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Dental Implant Surface and Materials

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A special issue of Materials (ISSN 1996-1944). This special issue belongs to the section "Biomaterials".

Deadline for manuscript submissions: closed (30 March 2020) | Viewed by 36974

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Prof. Dr. Lia Rimondini

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Department of Health Sciences, Università “A. Avogadro”, Novara, Italy
Interests: biomaterials; dental materials;materials for bone, periodontal and dental tissues regeneration
Special Issues, Collections and Topics in MDPI journals

Dr. Andrea Cochis

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Department of Health Sciences, Università del Piemonte Orientale, Alessandria-Novara- Vervelli, Italy
Interests: oral implants; biomaterials; tissue regeneration
Special Issues, Collections and Topics in MDPI journals

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Dear Colleagues,

Rral implant and subsequent prosthetic treatment has become a common method to treat full and partial edentulism. The clinical outcomes depend on many factors including proper diagnostic and surgical procedures, careful choice of the devices and proper follow-up.

The surfaces topography, chemical-physical and chemical properties of the implants play a pivotal role in the healing process and in speeding up final restorations and functional loading even in sites with poor bone quality and patients with unbalance healthy conditions.

Particularly proper surface functionalization using bioactive molecules and ions allow to address tissue healing, counteract infection and maintain healthy tissues over the time.

The Special Issue is focused on the emerging concepts on the role of surfaces in addressing fast and successful osseo- and soft tissues integration around oral implants and in maintenance of the clinical performances.

Topics include, but not limited to:

New concepts on oral implants surface design and manufacturing to improve osseointegration;
New concepts on oral implants surface design and manufacturing fostering and improving soft tissues integration;
Novel technologies to functionalized oral implant surfaces addressing immunomodulation;
New concepts on oral biofilm control around implants;
Novel technologies to prevent or treat oral implant mucositis or periimplantitis;
Novel technologies to avoid corrosion or degradation.

I hope that new ideas will promote a fast development of this exciting topic of surface modification of oral implants, and I invite you to submit your contributions to this Special Issue with the best of your research activities.

Prof. Lia Rimondini
Dr. Andrea Cochis
Guest Editors

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Keywords

oral implants
biomaterials
surface functionalization
surface modification
osteointegration
soft tissue integration
tissue regeneration

Published Papers (11 papers)

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Research

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11 pages, 3790 KiB

Open AccessArticle

Effects of Different Divalent Cation Hydrothermal Treatments of Titanium Implant Surfaces for Epithelial Tissue Sealing

by Xudiyang Zhou, Ikiru Atsuta, Yasunori Ayukawa, Ikue Narimatsu, Tianren Zhou, Jiangqi Hu and Kiyoshi Koyano

Materials 2020, 13(9), 2038; https://doi.org/10.3390/ma13092038 - 27 Apr 2020

Cited by 10 | Viewed by 2246

Abstract

The improvement of peri-implant epithelium (PIE) adhesion to titanium (Ti) may promote Ti dental implant stability. This study aims to investigate whether there is a positive effect of Ti hydrothermally treated (HT) with calcium chloride (CaCl₂), zinc chloride (ZnCl₂), and strontium chloride (SrCl₂) on promoting PIE sealing. We analyzed the response of a rat oral epithelial cell (OEC) culture and performed an in vivo study in which the maxillary right first molars of rats were extracted and replaced with calcium (Ca)-HT, zinc (Zn)-HT, strontium (Sr)-HT, or non-treated control (Cont) implants. The OEC adhesion on Ca-HT and Zn-HT Ti plates had a higher expression of adhesion proteins than cells on the Cont and Sr-HT Ti plates. Additionally, the implant PIE of the Ca-HT and Zn-HT groups revealed better expression of immunoreactive laminin-332 (Ln-322) at 2 weeks after implantation. The Ca-HT and Zn-HT groups also showed better attachment at the implant–PIE interface, which inhibited horseradish peroxidase penetration. These results demonstrated that the divalent cations of Ca (Ca²⁺) and Zn (Zn²⁺)-HT improve the integration of epithelium around the implant, which may facilitate the creation of a soft barrier around the implant to protect it from foreign body penetration. Full article

(This article belongs to the Special Issue Dental Implant Surface and Materials)

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12 pages, 1978 KiB

Open AccessArticle

Long-Term Clinical Outcomes of Treatment with Dental Implants with Acid Etched Surface

by Eugenio Velasco-Ortega, Alvaro Jimenez-Guerra, Loreto Monsalve-Guil, Ivan Ortiz-Garcia, Ana I. Nicolas-Silvente, Juan J. Segura-Egea and Jose Lopez-Lopez

Materials 2020, 13(7), 1553; https://doi.org/10.3390/ma13071553 - 27 Mar 2020

Cited by 19 | Viewed by 2669

Abstract

Implant dentistry constitutes a therapeutic modality in the prosthodontic treatment of partially and totally edentulous patients. This study reports a long-term evaluation of treatment by the early loading of acid-etched surface implants. Forty-eight partially and totally edentulous patients were treated with 169 TSA Defcon® acid-etched surface implants for prosthodontic rehabilitation. Implants were loaded after a healing free-loading period of 6–8 weeks in mandible and maxilla, respectively. Implant and prosthodontic clinical findings were followed during at least 17 years. Clinical results indicate a survival and success rate of implants of 92.9%, demonstrating that acid-etched surface achieves and maintains successful osseointegration. Five implants in three patients were lost during the healing period. Sixty-five prostheses were placed in 45 patients over the remaining 164 implants, 30 single crowns, 21 partially fixed bridges, 9 overdentures, and 5 full-arch fixed rehabilitations. A total of 12 implants were lost during the follow-up period. Mean marginal bone loss was 1.91 ± 1.24 mm, ranging from 1.1 to 3.6 mm. The most frequent complication was prosthetic technical complications (14.2%), followed by peri-implantitis (10.6%). The mean follow-up was of 214.4 months (208–228 months). Prosthodontic rehabilitation with an early-loading protocol over acid-etched surface implants is a successful implant treatment. Full article

(This article belongs to the Special Issue Dental Implant Surface and Materials)

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14 pages, 2391 KiB

Open AccessArticle

Effect of the Compositions on the Biocompatibility of New Alumina–Zirconia–Titania Dental Ceramic Composites

by Amani Khaskhoussi, Luigi Calabrese, Monica Currò, Riccardo Ientile, Jamel Bouaziz and Edoardo Proverbio

Materials 2020, 13(6), 1374; https://doi.org/10.3390/ma13061374 - 18 Mar 2020

Cited by 14 | Viewed by 2762

Abstract

Dental implant biomaterials are expected to be in contact with living tissues, therefore their toxicity and osseointegration ability must be carefully assessed. In the current study, the wettability, cytotoxicity, and genotoxicity of different alumina–zirconia–titania composites were evaluated. The surface wettability determines the biological event cascade in the bioceramic/human living tissues interface. The measured water contact angle indicated that the wettability strongly depends on the ceramic composition. Notwithstanding the contact angle variability, the ceramic surfaces are hydrophilic. The cytotoxicity of human gingival fibroblast cells with materials, evaluated by an (3-(4,5 methylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) test, revealed an absence of any cytotoxic effect. A relationship was found between the cell viability and the wettability. It was subsequently deduced that the cell viability increases when the wettability increases. This effect is more pronounced when the titania content is higher. Finally, a comet test was applied as complementary biocompatibility test to detect any changes in fibroblast cell DNA. The results showed that the DNA damage is intimately related to the TiO₂ content. Genotoxicity was mainly attributed to ceramic composites containing 10 wt.% TiO₂. Our research revealed that the newly developed high performance alumina–zirconia–titania ceramic composites contain less than 10 wt.% TiO₂, and display promising surface properties, making them suitable for dental implantology applications. Full article

(This article belongs to the Special Issue Dental Implant Surface and Materials)

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13 pages, 2867 KiB

Open AccessArticle

Fluoride Modification of Titanium Surfaces Enhance Complement Activation

by Maria H. Pham, Håvard J. Haugen and Janne E. Reseland

Materials 2020, 13(3), 684; https://doi.org/10.3390/ma13030684 - 03 Feb 2020

Cited by 4 | Viewed by 2456

Abstract

Immediately after dental implant insertion, blood will be in direct contact and interact with the implant surface and activates inflammatory responses and complement cascades within seconds. The aim of the present study was to determine the ability of fluoride-modified titanium surfaces to activate complement cascades using the human buffy coat as model. The buffy coats were exposed to hydrofluoric acid-modified surfaces for a short time and its responses were compared to controls. Identification and quantification of complement cascade biomarkers were conducted using ELISA kits and multianalyte profiling using Luminex. A lower level of C3 at 30 min and increased levels of C4, MIP-4, CRP, and pigment epithelium-derived factor at 360 min were found on modified surfaces as compared to controls. We found no significant differences in the levels of C3a, C5a, C Factor H, α2M, ApoA1, ApoC3, ApoE, Prealbumin, α1AT, and SAP in modified surfaces in the buffy coats. We conclude that titanium surfaces treated with hydrofluoric acid modify the levels of specific biomarkers related to the complement cascade and angiogenesis and, thus, tissue growth, remodeling and repair, as this may play a role in the enhanced clinical performance of fluoride-modified Ti dental implants. Full article

(This article belongs to the Special Issue Dental Implant Surface and Materials)

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10 pages, 1468 KiB

Open AccessArticle

Effect of Hydrothermal Treatment with Distilled Water on Titanium Alloy for Epithelial Cellular Attachment

by Yasushige Sakamoto, Yasunori Ayukawa, Akihiro Furuhashi, Michimasa Kamo, Junji Ikeda, Ikiru Atsuta, Takuya Haraguchi and Kiyoshi Koyano

Materials 2019, 12(17), 2748; https://doi.org/10.3390/ma12172748 - 27 Aug 2019

Cited by 6 | Viewed by 2409

Abstract

The enhancement of oral epithelial adhesion to the trans-mucosal material of dental implants may improve their long-term stability. The aim of this study is to investigate whether hydrothermal treatment with distilled water (HT-DW) applied to a Ti-6Al-4V (Ti64) alloy could improve epithelial cellular attachment. We hypothesized that this treatment would enhance the adsorption of proteins and the adhesion of gingival epithelial GE1 cells. This treatment changed the surface crystal structure into an anatase type of titanium oxide without an apparent change of surface roughness or topography. Nitrogen was not detected on the HT-DW-treated Ti64, which indicates decontamination. HT-DW-treated Ti64 exhibited a hydrophilic surface with a less than 10° angle of water contact. Adsorption of laminin-332 to the HT-DW-treated Ti64 was significantly greater than that of the untreated Ti64 plates (64). The number of GE1 cells on the HT-DW-treated Ti64 at 1 and 3 days was significantly lower than that on 64; however, cell adhesion strength on HT-DW was greater, with a higher expression of integrin β4, compared with 64. This indicates that the HT-DW treatment of Ti64 improves the integration of GE1 cells, which might facilitate the development of a soft tissue barrier around the implant. Full article

(This article belongs to the Special Issue Dental Implant Surface and Materials)

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11 pages, 8774 KiB

Open AccessArticle

Human Osteoblast Cell Behaviour on Titanium Discs Treated with Argon Plasma

by Carolina González-Blanco, María Rizo-Gorrita, Irene Luna-Oliva, María-Ángeles Serrera-Figallo, Daniel Torres-Lagares and José-Luis Gutiérrez-Pérez

Materials 2019, 12(11), 1735; https://doi.org/10.3390/ma12111735 - 28 May 2019

Cited by 10 | Viewed by 2824

Abstract

(1) Background. Titanium is characterized by its biocompatibility and resistance to stress and fatigue. Treatment with argon plasma may favour growth of human osteoblasts with respect to cell adhesion and proliferation. The aim of this study was to analyse the behaviour of human osteoblasts (MG-63) on Grade IV and V titanium possessing a sand-blasted, acid-etched (SLA) surface. SLA is a widely used surface treatment to create micro- and macroretentions to enhance osteoconductive properties on the surface. (2) Methods. One group of each grade of titanium was decontaminated with argon plasma and compared. On each disc, 20 × 10⁴ cells were cultivated for morphological analysis, study of cell viability (regarding a negative control [100% viability]) and mitochondrial energy balance. (3) Results. At 24 h titanium treated with SLA showed a higher percentage of cell viability (47.3 ± 8.1%) compared to titanium IV treated with argon plasma, which presented a percentage of 79.1 ± 1.1%. Grade V titanium treated with argon plasma presented a higher viability percentage 91.3 ± 3.0% whereas nontreated Grade V titanium presented 53.3 ± 4.0%. Cells cultivated on the surfaces with an argon-plasma treatment were enlarged in comparison to non-treated discs. The cells with smaller circularity with a greater spread and spindle shape were the ones cultivated on the Grade V titanium surface. Cells seeded on treated titanium IV and titanium V, treated or not, showed higher mitochondrial activity over nontreated titanium IV. (4) Conclusions. Cells cultivated on those Grade V titanium discs that were decontaminated with argon plasma presented higher levels of cell adhesion and proliferation, lower mitochondrial damage and a higher mean cell area compared to those not decontaminated with argon plasma. Full article

(This article belongs to the Special Issue Dental Implant Surface and Materials)

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12 pages, 6212 KiB

Open AccessArticle

Microbiological and SEM-EDS Evaluation of Titanium Surfaces Exposed to Periodontal Gel: In Vitro Study

by Sara Bernardi, Serena Bianchi, Anna Rita Tomei, Maria Adelaide Continenza and Guido Macchiarelli

Materials 2019, 12(9), 1448; https://doi.org/10.3390/ma12091448 - 04 May 2019

Cited by 27 | Viewed by 3492

Abstract

Inflammatory diseases affecting the soft and hard tissues surrounding an implant represent a new challenge in contemporary implant dentistry. Among several methods proposed for the decontamination of titanium surfaces, the administration of topical 14% doxycycline gel seems to be a reliable option. In the present study, we evaluated the microbial effect of 14% doxycycline gel applied on titanium surfaces and exposed to human salivary microbes in anaerobic conditions. We also examined the composition of the exposed surfaces to assess the safe use of periodontal gel on titanium surfaces. Six anatase and six type 5 alloy titanium surfaces were used and divided into two groups: The test group and the positive control group. Both were cultured with human salivary samples in anaerobic conditions. On the test groups, 240 mg of periodontal gel was applied. The microbial assessment was performed with a colony-forming unit (CFU) count and matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) to identify the species. The surface integrity was assessed using scanning electron microscopy-energy dispersive X-ray spectrometry (SEM-EDS). The results demonstrated the microbial efficacy of the 14% doxycycline periodontal gel and its safe use on titanium surfaces. However, the SEM observations revealed the permanence of the gel on the titanium surfaces due to the physical composition of the gel. This permanence needs to be further investigated in vivo and a final polishing protocol on the titanium surface is recommended. Full article

(This article belongs to the Special Issue Dental Implant Surface and Materials)

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13 pages, 1694 KiB

Open AccessFeature PaperArticle

Biofilm Removal and Bacterial Re-Colonization Inhibition of a Novel Erythritol/Chlorhexidine Air-Polishing Powder on Titanium Disks

by Magda Mensi, Andrea Cochis, Annamaria Sordillo, Francesca Uberti and Lia Rimondini

Materials 2018, 11(9), 1510; https://doi.org/10.3390/ma11091510 - 23 Aug 2018

Cited by 18 | Viewed by 4032

Abstract

Air-polishing with low abrasiveness powders is fast arising as a valid and mini-invasive instrument for the management of biofilm colonizing dental implants. In general, the reported advantage is the efficient removal of plaque with respect to the titanium integrity. In the present study, we evaluated the in situ plaque removal and the preventive efficacy in forestalling further infection of an innovative erythritol/chlorhexidine air-polishing powder and compared it with sodium bicarbonate. Accordingly, two peri-implantitis-linked biofilm formers, strains Staphylococcus aureus and Aggregatibacter actinomycetemcomitans, were selected and used to infect titanium disks before and after the air-polishing treatment to test its ability in biofilm removal and re-colonization inhibition, respectively. Biofilm cell numbers and viability were assayed by colony-forming unit (CFU) count and metabolic-colorimetric (2,3-Bis-(2-Methoxy-4-Nitro-5-Sulfophenyl)-2H-Tetrazolium-5-Carboxanilide) (XTT) assay. Results demonstrated that air-polishing performed with either sodium bicarbonate or erythritol/chlorhexidine was effective in reducing bacteria biofilm viability and number on pre-infected specimens, thus showing a similar ability in counteracting existing infection in situ; on the other hand, when air-polished pre-treated disks were infected, only erythritol/chlorhexidine powder showed higher post-treatment biofilm re-growth inhibition. Finally, surface analysis via mechanical profilometry failed to show an increase in titanium roughness, regardless of the powder selected, thus excluding any possible surface damage due to the use of either sodium bicarbonate or erythritol/chlorhexidine. Full article

(This article belongs to the Special Issue Dental Implant Surface and Materials)

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15 pages, 1070 KiB

Open AccessArticle

Efficacy of Proanthocyanidins from Pelargonium sidoides Root Extract in Reducing P. gingivalis Viability While Preserving Oral Commensal S. salivarius

by Nijole Savickiene, Aiste Jekabsone, Lina Raudone, Asmaa S. Abdelgeliel, Andrea Cochis, Lia Rimondini, Elina Makarova, Solveiga Grinberga, Osvalds Pugovics, Maija Dambrova, Ingrida M. Pacauskiene, Nomeda Basevičiene and Pranas Viškelis

Materials 2018, 11(9), 1499; https://doi.org/10.3390/ma11091499 - 22 Aug 2018

Cited by 29 | Viewed by 5066

Abstract

Bacterial resistance to antibiotics and the disruption of beneficial microbiota are key problems in contemporary medicine and make the search for new, more efficient infection treatment strategies among the most important tasks in medicine. Multicomponent plant-derived preparations with mild antibacterial activity created by many simultaneous mechanisms together with anti-inflammatory, innate immune and regenerative capacity-stimulating properties are good candidates for this therapy, and proanthocyanidins are among the most promising compounds of this sort. In this study, we have isolated proanthocyanidins from Pelargonium sidoides DC root extract and characterized and compared the composition, antioxidant properties and antibacterial activity of the proanthocyanidin fraction with those of the whole extract. The results revealed that proanthocyanidins had significantly stronger antioxidant capacity compared to the root extract and exhibited a unique antibacterial action profile that selectively targets Gram-negative keystone periodontal and peri-implant pathogenic strains, such as Porphyromonas gingivalis, while preserving the viability of beneficial oral commensal Streptococcus salivarius. The finding suggests that proanthocyanidins from Pelargonium sidoides root extract are good candidates for the prolonged and harmless treatment of infectious diseases. Full article

(This article belongs to the Special Issue Dental Implant Surface and Materials)

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30 pages, 4747 KiB

Open AccessFeature PaperReview

Surface Characterization of Electro-Assisted Titanium Implants: A Multi-Technique Approach

by Stefania Cometa, Maria A. Bonifacio, Ana M. Ferreira, Piergiorgio Gentile and Elvira De Giglio

Materials 2020, 13(3), 705; https://doi.org/10.3390/ma13030705 - 05 Feb 2020

Cited by 13 | Viewed by 3123

Abstract

The understanding of chemical–physical, morphological, and mechanical properties of polymer coatings is a crucial preliminary step for further biological evaluation of the processes occurring on the coatings’ surface. Several studies have demonstrated how surface properties play a key role in the interactions between biomolecules (e.g., proteins, cells, extracellular matrix, and biological fluids) and titanium, such as chemical composition (investigated by means of XPS, TOF-SIMS, and ATR-FTIR), morphology (SEM–EDX), roughness (AFM), thickness (Ellipsometry), wettability (CA), solution–surface interactions (QCM-D), and mechanical features (hardness, elastic modulus, adhesion, and fatigue strength). In this review, we report an overview of the main analytical and mechanical methods commonly used to characterize polymer-based coatings deposited on titanium implants by electro-assisted techniques. A description of the relevance and shortcomings of each technique is described, in order to provide suitable information for the design and characterization of advanced coatings or for the optimization of the existing ones. Full article

(This article belongs to the Special Issue Dental Implant Surface and Materials)

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20 pages, 13299 KiB

Open AccessReview

Sandblasted and Acid Etched Titanium Dental Implant Surfaces Systematic Review and Confocal Microscopy Evaluation

by Gabriele Cervino, Luca Fiorillo, Gaetano Iannello, Dario Santonocito, Giacomo Risitano and Marco Cicciù

Materials 2019, 12(11), 1763; https://doi.org/10.3390/ma12111763 - 30 May 2019

Cited by 62 | Viewed by 5080

Abstract

The field of dental implantology has made progress in recent years, allowing safer and predictable oral rehabilitations. Surely the rehabilitation times have also been reduced, thanks to the advent of the new implant surfaces, which favour the osseointegration phases and allow the clinician to rehabilitate their patients earlier. To carry out this study, a search was conducted in the Pubmed, Embase and Elsevier databases; the articles initially obtained according to the keywords used numbered 283, and then subsequently reduced to 10 once the inclusion and exclusion criteria were applied. The review that has been carried out on this type of surface allows us to fully understand the features and above all to evaluate all the advantages or not related. The study materials also are supported by a manufacturing company, which provided all the indications regarding surface treatment and confocal microscopy scans. In conclusion, we can say that, thanks to these new surfaces, it has been possible to shorten the time necessary to obtain osseointegration and, therefore, secondary stability on the part of implants. The surfaces, therefore, guarantee an improved cellular adhesion and thanks to the excellent wettability all the biological processes that derive from it, such as increases in the exposed implant surface, resulting in an increase in bone-implant contact (BIC). Full article

(This article belongs to the Special Issue Dental Implant Surface and Materials)

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