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Materials for Bone and Dental Hard Tissue Substitutes

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A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Materials Science and Engineering".

Deadline for manuscript submissions: closed (30 January 2024) | Viewed by 29187

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Dr. Maciej Dobrzyński

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Department of Pediatric Dentistry and Preclinical Dentistry, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland
Interests: nanomaterials; titanium alloys; composites; nanohydroxyapatite applications; scaffolds; dental CAD/CAM materials; bone regeneration; dental bioengineering; biomaterial’s surface modification; lasers in medicine; environmental dentistry
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Special Issue Information

Dear Colleagues,

Bone and dental hard tissue defects still remain a challenge in regenerative medicine. Moreover, modern materials used in endodontics and endoprosthodontics allow the regeneration of dental tissues, which prolongs a tooth’s usefulness. Technological progress of materials influences the efficacy of implantology by supressing the resorption of alveolar bone. Modern technologies in materials are also successfully used in the case of mandible or maxilla reconstruction.

The aim of this Special issue should be discussed in articles on the possible use of mineralized tissue substitutes in biomedicine. The successful use of bone substitute material allows a natural duplication of the bone cellular system. Better understanding of the bony nanostructure contributes to the more efficient use of synthetic biomaterials as bone substitutes. Special attention will be paid to new methods of nanomaterials use in bone substitution, as well as their effectiveness in clinical procedures.

Topics to be covered in this Special Issue include:

Characterization of bone substitute materials;
Application of bone substitute materials;
Biocompatibility assessment of bone substitute materials;
Physicochemical properties of bone substitute materials;
Nanoscale modifications of bone substitute materials;
3D printing in bone regeneration;
Modern titanium alloys in maxilla or mandible reconstructions;
Materials in endodontic surgery;
Mechanical and biocompatible properties of CAD/CAM restorative materials;
Materials in osteosynthesis and implantology.

Dr. Maciej Dobrzyński
Guest Editor

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Keywords

Hydroxiapatite
Alloplastic materials
Xenografts
Nanomaterials-based bone regeneration
3D-printed scaffolds
Dental implants
Titanium alloys
Endodontic materials
Dental CAD/CAM materials

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Related Special Issue

Materials for Bone and Dental Hard Tissue Substitutes—2nd Edition in Applied Sciences

Published Papers (10 papers)

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Research

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14 pages, 2787 KiB

Open AccessArticle

Validation of a Novel Diagnostic Test for Assessing the Risk of Peri-Implantitis through the Identification of the Microorganisms Present: A Pilot Clinical Study of Periopoc

by María José Moya-Villaescusa, Arturo Sánchez-Pérez, Nour Mehdi Al-Lal, Alfonso Jornet-García and José María Montoya-Carralero

Appl. Sci. 2023, 13(17), 9621; https://doi.org/10.3390/app13179621 - 25 Aug 2023

Viewed by 1168

Abstract

The aim of this parallel group study was to determine the clinical applicability of a newly developed bacterial test. We evaluated the ability of the test to detect five bacteria associated with peri-implantitis: Porphyromonas gingivalis, Tannerella forsythia, Aggregatibacter actinomycetemcomitans, Prevotella intermedia, and Treponema denticola. Sensitivity, specificity, and positive and negative predictive values were established. Furthermore, by analyzing the pre-test and post-test probabilities, likelihood ratios were established, and a Fagan nomogram was constructed. As the standard, the clinical criteria of peri-implantitis adopted in the latest classification of peri-implant diseases of 2018 were used. The sample consisted of 13 patients clinically diagnosed with peri-implantitis (various implant brands) with at least 1 year of loading, of whom 11 were included in the study. The healthy group comprised 10 patients who received implants (Ticare inhex hybrid) at the university dental clinic and were monitored and exhibited no signs or symptoms of peri-implantitis during 1 year of loading. The results indicated that this test has high sensitivity and low specificity; therefore, positive results will be of great importance for a confirmatory diagnosis of peri-implantitis. However, the test is not suitable as a screening tool. Full article

(This article belongs to the Special Issue Materials for Bone and Dental Hard Tissue Substitutes)

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16 pages, 4164 KiB

Open AccessArticle

Safety and Effectiveness of Conventional Commercial Products for Professional Tooth Bleaching: Comparative Ex Vivo Study Using AFM Microscopy and Nanoindentation

by Claudio Pasquale, Nicola De Angelis, Fabrizio Barberis, Alberto Lagazzo, Elena Dellacasa, Davide Biggio, Matteo Schiaffino, Roberto Raiteri, Luca Ceseracciu, Stefano Benedicenti and Andrea Amaroli

Appl. Sci. 2023, 13(16), 9371; https://doi.org/10.3390/app13169371 - 18 Aug 2023

Cited by 2 | Viewed by 2984

Abstract

In modern times, patients are not only seeking oral health but also aiming for a flawless smile. Despite the progress made in aesthetic dentistry, there are instances where insufficient teeth whitening results contrast with the considerable cost of professional treatments. Patient discomfort and the potential for tooth damage further compound these challenges. In this study, we conducted a comparative split-mouth ex vivo investigation to evaluate the innovative BlancOne ULTRA⁺ (IDS SpA) in comparison with established professional products: Opalescence Extraboost (ULTRADENT), Zoom WhiteSpeed (Philips Research Eindhoven High Tech), and Pola Office (SDI Limited). Our initial focus was on the whitening effectiveness of each product, which was measured using a spectrophotometer. Subsequently, we assessed any structural changes in enamel post-treatment using an atomic force microscope (AFM) and a nanoindentation procedure. All tested bleaching agents demonstrated teeth-brightening effects. BlancOne ULTRA⁺, Zoom WhiteSpeed, and Pola Office caused minor alterations in the texture of the enamel surface within nanometric limits. However, Opalescence Extraboost exhibited notably more pronounced changes, indicating significant modifications in surface roughness and potential reductions in material hardness due to consequential shifts in mechanical properties. BlancOne ULTRA⁺ appears to offer the most favourable cost–benefit outcome. Full article

(This article belongs to the Special Issue Materials for Bone and Dental Hard Tissue Substitutes)

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13 pages, 1228 KiB

Open AccessArticle

Influence of the Number of Microthreads on Marginal Bone Loss: A Five-Year Retrospective Clinical Study in Humans

by Alfonso Jornet-García, Arturo Sánchez-Pérez, Pablo Planes-Nicolás, José M. Montoya-Carralero and María J. Moya-Villaescusa

Appl. Sci. 2023, 13(6), 3936; https://doi.org/10.3390/app13063936 - 20 Mar 2023

Cited by 2 | Viewed by 2034

Abstract

The purpose of the present study was to evaluate the clinical and radiographic outcomes of the number of microthreads on marginal bone over 5 years. Thirty-two implants were placed in 32 patients with partially edentulous maxillae or mandibles. Two implants with the same characteristics were placed: the first one had a 1 mm crest module and 3 microthreads (Q); and the second one had a 3 mm crest module and nine microthreads (S). The prosthesis was inserted 3 months after implant placement. Clinical and radiographic examinations were performed at the one-week, one-month, and three-month follow-up visits and then every six months until a five-year follow-up period was completed. After 5 years of follow-up, five patients withdrew from the study. Complete data were available for 27 implants, with a 100% implant survival rate. No cases of peri-implantitis were diagnosed. The average bone loss was 0.65 mm (C.I. 0.21–1.09) for Q implants and 0.86 mm (C.I. 0.39–1.33) for S implants, with no statistically significant difference. The bone level does not vary between implants with three and nine microthreads or with a 1 mm and 3 mm crest module. No differences in clinical parameters were found. Full article

(This article belongs to the Special Issue Materials for Bone and Dental Hard Tissue Substitutes)

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10 pages, 3595 KiB

Open AccessArticle

Customer Complaints as an Evaluation Tool Assessing the Performance and Clinical Suitability of Different Implant Design

by Stefan Ihde and Łukasz Pałka

Appl. Sci. 2022, 12(22), 11394; https://doi.org/10.3390/app122211394 - 10 Nov 2022

Viewed by 1198

Abstract

During an assessment of dental implant design effectiveness, most of the data are acquired from clinical or animal studies performed by researchers and clinicians. In order to represent scientific significance, those studies have to be properly designed, focusing on a precisely chosen aspect with inclusion and exclusion criteria. The last of these, especially, can create major limitations for the data collection. In order to create a reliable, complete overview of different implant suitability, the data from a single customer can also be a valuable input in dental science. The aim of the study was to compare if the type of implants returned corresponded with sales figures for this type of implant or if there were any differences in the number of complaints. Customer complaints regarding dental implants produced by the same manufacturer acquired from dental professionals from different countries were evaluated over a fixed period of time. After having compared the number of complaints regarding implants to the number of sold implants, it was evident that single-piece implants and those with a polished surface used for immediate loading were significantly less likely to generate customer complaints than conventional two-stage systems (p < 0.001) with rough surfaces and larger endosseous diameters. Full article

(This article belongs to the Special Issue Materials for Bone and Dental Hard Tissue Substitutes)

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10 pages, 1865 KiB

Open AccessArticle

Peri-Implantitis: A New Definition Proposal Based on Unnatural Spatial Arrangement and Late Mechanical Coupling between Two Cortical Bone Layers during Osseointegration Phase Part II

by Stefan Ihde, Antonina Ihde, Olga Sipic and Łukasz Pałka

Appl. Sci. 2022, 12(11), 5589; https://doi.org/10.3390/app12115589 - 31 May 2022

Cited by 4 | Viewed by 2685

Abstract

To date, the term peri-implantitis has been mostly associated with bacterial or foreign body reaction as primary factors of its development. Because of this, researchers’ and clinicians’ attention regarding treatment possibilities were directed into the solutions on the basis of surface modifications, debridement, and antibiotics. After years of clinical observations and poor results in treatment of peri-implantitis, a new proposal of this condition is presented, shifting our way of thinking regarding bone and implant interactions. In the second part of the paper presenting a new definition of peri-implantitis, we focused on a biological explanation of the bone behavior at the bone–implant interface. The main conclusion is that PI is not an “infectious disease”, but rather the result of natural changes of the bone’s morphology in response to implant such as a decrease in convexity of the outer surface of the bone and subsequently a decrease in concavity of the inner bone. Full article

(This article belongs to the Special Issue Materials for Bone and Dental Hard Tissue Substitutes)

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8 pages, 1559 KiB

Open AccessArticle

Peri-Implantitis: A New Definition Proposal Based on Unnatural Spatial Arrangement and Late Mechanical Coupling between Two Cortical Bone Layers during Osseointegration Phase: Part I

by Stefan Ihde, Antonina Ihde, Olga Sipic and Łukasz Pałka

Appl. Sci. 2022, 12(9), 4317; https://doi.org/10.3390/app12094317 - 25 Apr 2022

Cited by 1 | Viewed by 1961

Abstract

Scientists have been speculating for three decades about the reasons for the occurrence of peri-implantitis around dental implants. Many theories have been proposed since the beginning of 1990. Since then, the dental profession has been exposed to a vast number of peri-implantitis cases, whereas the “disease” had been unknown before this time. However, the situation has not improved because we focus more on how to treat the problem instead of trying to understand it completely. The aim of this paper is to present a purely bone-based explanation for the beginning of the “bone loss” process around already “osseointegrated” implants. Conclusion: There are a number of possible chain reactions of physiological bone response to dental implants which may explain the occurrence of peri-implantitis. Bacteria and “immunological reactions” may not be the main causes of this disease. In the first part, the authors present the principles of bone biology and physiology based on the theories of Donath, Jansen and Frost and transfer them to the field of implantology. They describe the stages of “osseointegration”, explaining the subsequent changes in the bone at the implant–bone interface. Full article

(This article belongs to the Special Issue Materials for Bone and Dental Hard Tissue Substitutes)

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13 pages, 21868 KiB

Open AccessArticle

Early Loading of Titanium Dental Implants with Hydroxyl Ion Modified Surface: A 12-Month Prospective Clinical Trial

by Maciej Krawiec, Jakub Hadzik, Marzena Dominiak, Wojciech Grzebieluch, Artur Błaszczyszyn and Paweł Kubasiewicz-Ross

Appl. Sci. 2021, 11(7), 2958; https://doi.org/10.3390/app11072958 - 25 Mar 2021

Cited by 4 | Viewed by 3248

Abstract

(1) Background: implant surface topology and active hydrophilic ions could have some benefit on implant osteointegration and stability; (2) methods: 40 adult patients, suffering from a single missing tooth in the aesthetic zone, were enrolled in the study. Each patient had a single titanium implant (Thommen SPI^®lement) inserted. The implant surface was obtained through conditioning using the Apliquiq system. Patients were divided into two equal groups depending on the implant’s diameter (3.5 and 4.0 mm). Each implant was loaded within four weeks. Stability levels, using the Ostell device, were checked immediately after implant placement and in four weeks; additionally, marginal bone loss (MBL) was calculated based on 12 months; (3) results: all implants survived the study. The average primary stability achieved for both groups was initially 71.59 ISQ (±4.04) and declined to 69.94 ISQ (±3.29) in four weeks. The average MBL was 0.2 mm (±0.88). There were no statistically important differences between groups. There was a positive correlation between the patient’s age and implant stability quotient (ISQ) values; (4) conclusions: hydrophilic surface implants can be used in a protocol for early functional occlusal loading. Higher values of primary stability positively influence the values of secondary stability, and the age of the patient affects the values of implant stability. Full article

(This article belongs to the Special Issue Materials for Bone and Dental Hard Tissue Substitutes)

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Review

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22 pages, 537 KiB

Open AccessReview

Different Approaches to the Regeneration of Dental Tissues in Regenerative Endodontics

by Anna M. Krupińska, Katarzyna Skośkiewicz-Malinowska and Tomasz Staniowski

Appl. Sci. 2021, 11(4), 1699; https://doi.org/10.3390/app11041699 - 14 Feb 2021

Cited by 5 | Viewed by 5775

Abstract

(1) Background: The regenerative procedure has established a new approach to root canal therapy, to preserve the vital pulp of the tooth. This present review aimed to describe and sum up the different approaches to regenerative endodontic treatment conducted in the last 10 years; (2) Methods: A literature search was performed in the PubMed and Cochrane Library electronic databases, supplemented by a manual search. The search strategy included the following terms: “regenerative endodontic protocol”, “regenerative endodontic treatment”, and “regenerative endodontics” combined with “pulp revascularization”. Only studies on humans, published in the last 10 years and written in English were included; (3) Results: Three hundred and eighty-six potentially significant articles were identified. After exclusion of duplicates, and meticulous analysis, 36 case reports were selected; (4) Conclusions: The pulp revascularization procedure may bring a favorable outcome, however, the prognosis of regenerative endodontics (RET) is unpredictable. Permanent immature teeth showed greater potential for positive outcomes after the regenerative procedure. Further controlled clinical studies are required to fully understand the process of the dentin–pulp complex regeneration, and the predictability of the procedure. Full article

(This article belongs to the Special Issue Materials for Bone and Dental Hard Tissue Substitutes)

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Other

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21 pages, 1225 KiB

Open AccessSystematic Review

Antibacterial Activity of Endodontic Gutta-Percha—A Systematic Review

by Jakub Kowalski, Joanna Rygas, Karolina Homa, Wojciech Dobrzyński, Rafal J. Wiglusz, Jacek Matys and Maciej Dobrzyński

Appl. Sci. 2024, 14(1), 388; https://doi.org/10.3390/app14010388 - 31 Dec 2023

Cited by 8 | Viewed by 3371

Abstract

Numerous failures in root canal treatment (RCT), attributed to the persistence of adverse microbiota, prompted researchers to develop a biomaterial with effective antibacterial and antifungal properties. In our systematic review, emphasis was placed on examining the antimicrobial properties of gutta-percha, the most used material for root canal obturation. The review aimed to determine whether gutta-percha demonstrated adequate antibacterial and antifungal features. Additionally, it sought to identify specific substances added to gutta-percha’s composition that could enhance the success rate of root canal obturation. On October 30, 2023, electronic searches were systematically performed in the PubMed, Web of Science (WoS), and Scopus databases using the specified keywords: ((antibacterial) OR (antimicrobial)) AND ((gutta-percha) OR guttapercha)). A thorough evaluation commenced, with an initial pool of 330 studies, from which 174 duplicates were methodically identified and removed. The ultimate dataset for qualitative synthesis consisted of 26 studies. The results of the compared studies did not unequivocally indicate whether the use of gutta-percha alone exhibits antibacterial or antifungal effects. Among the six studies demonstrating results supporting gutta-percha’s antimicrobial activity, five showed activity against Enterococcus faecalis. Conversely, six studies concluded that gutta-percha lacks any discernible antimicrobial features. One study even suggested that gutta-percha might promote the progression of bacterial development. However, eight out of nine studies demonstrated an increase in gutta-percha’s antimicrobial properties after the addition of chlorhexidine. Furthermore, calcium hydroxide and iodoform also improved gutta-percha’s properties, showing promising results. Unfortunately, none of the materials added to gutta-percha displayed comprehensive improvement in its antimicrobial efficacy, including activity against Enterococcus faecalis. The review demonstrated the benefit of enhancing gutta-percha with chlorhexidine, calcium hydroxide, and iodoform. Nevertheless, achieving the inactivation of Enterococcus faecalis posed a challenge. Full article

(This article belongs to the Special Issue Materials for Bone and Dental Hard Tissue Substitutes)

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12 pages, 4024 KiB

Open AccessCase Report

Fresh–Frozen Allogenic Bone Graft Usage in Treatment of an Odontogenic Keratocyst in the Mandible

by Kamil Nelke, Klaudiusz Łuczak, Maciej Janeczek, Edyta Pasicka, Krzysztof Żak, Marceli Łukaszewski, Radosław Jadach and Maciej Dobrzyński

Appl. Sci. 2023, 13(3), 1234; https://doi.org/10.3390/app13031234 - 17 Jan 2023

Cited by 1 | Viewed by 2556

Abstract

There are many cysts and tumors which might occur in the mandibular and maxillary bones. Their origin can be either odontogenic or non-odontogenic. One of the most common odontogenic cysts is the odontogenic keratocyst (OKC). Its nomenclature and classification have changed many times over years, from a tumor to, finally, a cyst. Nowadays, its treatment has not greatly changed, however, it is related to a potential recurrence rate more than any other cyst of odontogenic origins. OKC size, localization, and possible cortical expansion towards adjacent soft tissues might influence the scope of treatment and possible reoccurrence in time. Each case is quite individual, and after removal of the pathology in some cases there can be a necessity for either bone grafting or any other reconstruction method to restore proper bone continuity. The size and the placement of OKC might influence pathological fracture occurrence or inappropriate healing if the bone cavity after cyst removal is not properly treated. A good healing potential can be achieved with xenograft bone substitutes or allograft fresh–frozen bones. On rare occasions, a titanium plate is used to ensure mandibular stability. In the following case report, an atypical case of a large OKC treated with fresh–frozen bone grafts, supported with collagen barrier material in the anterior mandible with buccal cortical expansion, will be presented. Full article

(This article belongs to the Special Issue Materials for Bone and Dental Hard Tissue Substitutes)

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