Search Results (461)

Titanium–aluminum–vanadium (Ti6Al4V) is a material chosen for spine, orthopedic, and dental implants due to its combination of desirable mechanical and biological properties. Lasers have been used to modify metal surfaces, enabling the generation of a surface on Ti6Al4V with distinct micro- and nano-scale structures. Studies indicate that topography with micro/nano features of osteoclast resorption pits causes bone marrow stromal cells (MSCs) and osteoprogenitor cells to favor differentiation into an osteoblastic phenotype. This study examined whether the biological response of human MSCs to Ti6Al4V surfaces is sensitive to laser treatment-controlled micro/nano-topography. First, 15 mm diameter Ti6Al4V discs (Spine Wave Inc., Shelton, CT, USA) were either machined (M) or additively manufactured (AM). Surface treatments included no laser treatment (NT), nanosecond laser (Ns), femtosecond laser (Fs), or nanosecond followed by femtosecond laser (Ns+Fs). Surface wettability, roughness, and surface chemistry were determined using sessile drop contact angle, laser confocal microscopy, X-ray photoelectron spectroscopy (XPS), and scanning electron microscopy (SEM). Human MSCs were cultured in growth media on tissue culture polystyrene (TCPS) or test surfaces. On day 7, the levels of osteocalcin (OCN), osteopontin (OPN), osteoprotegerin (OPG), and vascular endothelial growth factor 165 (VEGF) in the conditioned media were measured. M NT, Fs, and Ns+Fs surfaces were hydrophilic; Ns was hydrophobic. AM NT and Fs surfaces were hydrophilic; AM Ns and Ns+Fs were hydrophobic. Roughness (Sa and Sz) increased after Ns and Ns+Fs treatment for both M and AM disks. All surfaces primarily consisted of oxygen, titanium, and carbon; Fs had increased levels of aluminum for both M and AM. SEM images showed that M NT discs had a smooth surface, whereas AM surfaces appeared rough at a higher magnification. Fs surfaces had a similar morphology to their respective NT disc at low magnification, but higher magnification revealed nano-scale bumps not seen on NT surfaces. AM Fs surfaces also had regular interval ridges that were not seen on non-femto laser-ablated surfaces. Surface roughness was increased on M and AM Ns and Ns+Fs disks compared to NT and Fs disks. OCN was enhanced, and DNA was reduced on Ns and Ns+Fs, with no difference between them. OPN, OPG, and VEGF levels for laser-treated M surfaces were unchanged compared to NT, apart from an increase in OPG on Fs. MSCs grown on AM Ns and Ns+Fs surfaces had increased levels of OCN per DNA. These results indicate that MSCs cultured on AM Ns and AM Ns+Fs surfaces, which exhibited unique roughness at the microscale and nanoscale, had enhanced differentiation to an osteoblastic phenotype. The laser treatments of the surface mediated this enhancement of MSC differentiation and warrant further clinical investigation. Full article

Background/Objectives: Tamoxifen, a selective estrogen receptor modulator widely used as an adjunct in the treatment of breast cancer, has known effects on bone metabolism, although its impact on osseointegration and cellular responses during early bone healing remains unclear. Understanding these effects is essential given the increasing use of dental implants in cancer survivors. The study aimed to observe the influence of tamoxifen on human osteosarcoma (SAOS-2) cells lines, as well on the osseointegration of titanium implants in ovariectomized female rats. Methods: SAOS-2 cells were incubated with Dulbecco’s modified growth medium. Six titanium (Ti) disks were used at each time point. The samples were divided into groups with the presence (TAM, n = 36) or not (CTR, n = 36) of tamoxifen in a concentration of 2 μM. In vivo, 72 animals were divided in groups with bilateral ovariectomy or SHAM and tamoxifen administration or not (15 mg/kg). Cell viability, mineralization rate, and collagen synthesis were assessed, as well as bone/implant contact (BIC) and bone ingrowth (BIN). Results: Tamoxifen caused a decrease in SAOS-2 viability, although an increase in the mineralization rate was observed. In vivo, the TAM groups presented higher BIC and BIN when compared to their control, but a lower percentage of mature collagen cells. Conclusions: Based on our findings, in vitro, the therapy with TAM slightly reduced the viability of SAOS-2 cells while significantly increasing the mineralization rate. In vivo, the therapy positively influenced BIC and BIN during the osseointegration phase. Full article

The thermo-chemical treatment of dental implants leads to the formation of sodium titanate crystals on their surface. When in contact with blood, these crystals dissolve and trigger an ionic exchange cascade, resulting in the formation of a calcium apatite layer. This study, carried out both in vitro and in an animal model, aimed to determine whether the cooling rate of the treatment affects the size of the deposited crystals, and whether this in turn influences wettability and early bone-to-implant contact (BIC). A total of 50 dental implants and 50 titanium discs were treated using four different cooling rates, along with a control group. Crystal size was analyzed on implant surfaces using scanning electron microscopy, and wettability was assessed on titanium discs using a goniometer. Finally, the implants were placed in the tibiae of 13 rabbits, and histological analysis was performed after three weeks to compare BIC among groups. Results suggest that a cooling rate of 75 °C/h produces smaller sodium titanate crystals, which are associated with significantly improved surface wettability and a higher percentage of bone-to-implant contact after 3 weeks of healing (p < 0.05). Full article

Background: The role of collagen membrane fixation during guided bone regeneration (GBR) remains debatable, particularly in post-extraction sockets with buccal defects and concomitant immediate implant placement. This study evaluated whether or not fixation with titanium pins improved regenerative outcomes. Methods: Six adult Beagle dogs received bilateral extractions of the fourth mandibular premolars. An implant was immediately placed in both the distal alveoli, and standardized buccal bone defects (5 mm height, 3–2 mm width) were prepared. All defects were filled with a slowly resorbing equine xenograft and covered by a resorbable pericardium membrane. At the test sites, the membrane was apically fixed with pins, while no fixation was applied to the control sites. After 3 months of healing, histomorphometric analyses were performed. Results: The vertical bone gain of the buccal crest was 3.2 mm in the test sites (pin group) and 2.9 mm in the control sites (no-pin) (p > 0.754). No significant difference was found in terms of bone-to-implant contact (BIC). However, residual graft particles were located significantly more coronally in the pin group compared to the no-pin group (p = 0.021). Morphometric analyses revealed similar new bone formation within the groups, but with higher amounts of residual xenograft and soft tissue in the pin group. Conclusions: Membrane fixation did not significantly enhance vertical bone gain, and although the slightly higher regeneration in the pin group (3.2 mm vs. 2.9 mm) may hold clinical relevance in esthetically sensitive areas and osseointegration, it appeared to limit apical migration of the grafting material. Full article

Enhancing osseointegration is a common goal for many titanium implant coatings, since the naturally forming oxides are often bioinert and exhibit less than ideal bone-to-implant contact. Oxide coating surface topographies, chemistries, and crystallinities are known to play key roles in enhancing bone–implant interactions. In the present study, two novel anodization processes were developed in electrolytes based on juiced navel oranges to create bioactive oxide coatings on commercially pure titanium (CPTi) surfaces. Both oxide groups revealed multi-scaled micro and nano surface topographies, significant Ca and P-dopant incorporation exhibiting Ca/P ratios similar to human bone (1.7 and 1.8), and physiologically relevant Mg uptake levels of <0.1% and 1.4 at%. XRD and FTIR analyses of each oxide revealed a combination of tricalcium phosphate and hydroxyapatite phases that showed carbonate substitutions indicative of bone-like apatite formation. Finally, VDI indentation testing revealed good adhesion strengths, minimal cracking, and no visible delamination for both oxides. In summary, the anodization processes in the present study were shown to produce carbonated tricalcium phosphate and apatite containing oxides with contrasting levels of Mg uptake that show much promise to improve future implant clinical outcomes. Full article

Porosity and roughened surfaces of implant materials have been shown to lead to improved cellular attachment and enhanced osseointegration. These topography changes in the surface also aid in the mechanical interlocking of the material to the bone. Polyetheretherketone (PEEK) has emerged as a popular alternative to titanium-based implants due to its lack of stress-shielding effect, radiolucency, and high chemical resistance. However, PEEK is bioinert, thus requiring surface modifications to elicit appropriate cellular responses that lead to successful osteointegration of the material in vivo. Sulfonation is a process used to modify the surface of PEEK, which can be controlled by varying parameters such as soak time and soak temperature, thereby fabricating a porous surface on the material. This work aimed to ensure the repeatability of a previously optimized sulfonated and hydrothermally treated PEEK surface and subsequently observe the mechanical properties, bacterial attachment, and cellular response of pre-osteoblast MC3T3-E1 cells on the surface. This study found that while all PEEK surfaces had similar cell and Staphylococcus aureus attachment, the sulfonated and hydrothermally treated PEEK (peak mean load of 605 N, p ≤ 0.0001) and the sulfonated only PEEK (peak mean load of 495 N, p = 0.0240) had a higher level of performance in expulsion testing than smooth PEEK due to its mechanical interlocking ability. Imaging and contact angle analysis confirm that a surface with repeatable porosity can be achieved. Full article

This study evaluated the effects of low-dose recombinant human bone morphogenetic protein-2 (rhBMP-2) coating in combination with vacuum plasma treatment on titanium implants, aiming to enhance osseointegration and bone regeneration while minimizing the adverse effects associated with high-dose rhBMP-2. In vitro analyses demonstrated that plasma treatment increased surface energy, promoting cell adhesion and proliferation. Additionally, it facilitated sustained rhBMP-2 release by enhancing protein binding to the implant surface. In vivo experiments using the four-beagle mandibular defect model were conducted with the following four groups: un-treated implants, rhBMP-2–coated implants, plasma-treated implants, and implants treated with both rhBMP-2 and plasma. Micro-computed tomography (micro-CT) and medical CT analyses revealed a significantly greater volume of newly formed bone in the combined treatment group (p < 0.05). Histological evaluation further confirmed superior outcomes in the combined group, showing significantly higher bone-to-implant contact (BIC), new bone area (NBA), and inter-thread bone density (ITBD) compared to the other groups (p < 0.05). These findings indicate that vacuum plasma treatment enhances the biological efficacy of low-dose rhBMP-2, representing a promising strategy to improve implant integration in compromised conditions. Further studies are warranted to determine the optimal clinical dosage. Full article

This study investigates the development of silver (Ag)-doped zirconia (ZrO₂) coatings deposited on 316LVM stainless steel via the unbalanced magnetron sputtering technique. The oxygen content in the Ar/O₂ gas mixture was systematically varied (12.5%, 25%, 37.5%, and 50%) to assess its influence on the resulting coating properties. In response to the growing demand for biomedical implants with improved durability and biocompatibility, the objective was to develop coatings that enhance both wear and corrosion resistance in physiological environments. The effects of silver incorporation and oxygen concentration on the structural, tribological, and electrochemical behavior of the coatings were systematically analyzed. X-ray diffraction (XRD) was employed to identify crystalline phases, while atomic force microscopy (AFM) was used to characterize surface topography prior to wear testing. Wear resistance was evaluated using a ball-on-plane tribometer under simulated prosthetic motion, applying a 5 N load with a bone pin as the counter body. Corrosion resistance was assessed through electrochemical impedance spectroscopy (EIS) in a physiological solution. Additionally, tribocorrosive performance was investigated by coupling tribological and electrochemical tests in Ringer’s lactate solution, simulating dynamic in vivo contact conditions. The results demonstrate that Ag doping, combined with increased oxygen content in the sputtering atmosphere, significantly improves both wear and corrosion resistance. Notably, the ZrO₂-Ag coating deposited with 50% O₂ exhibited the lowest wear volume (0.086 mm³) and a minimum coefficient of friction (0.0043) under a 5 N load. This same coating also displayed superior electrochemical performance, with the highest charge transfer resistance (38.83 kΩ·cm²) and the lowest corrosion current density (3.32 × 10⁻⁸ A/cm²). These findings confirm the high structural integrity and outstanding tribocorrosive behavior of the coating, highlighting its potential for application in biomedical implant technology. Full article

Background/Objectives: The aim of the present study is to evaluate the influence of the healing abutment height on secondary implant stability measured by resonance frequency analysis. In this prospective observational clinical study of 30 implants, the secondary stability of the implant was measured via resonance frequency analysis of the abutment during the osseointegration process. Methods: Two groups were compared: a <4 group (n = 15), with a space between the healing abutment and the antagonist of <4 mm, and a ≥4 group (n = 15), with a space of ≥4 mm. Results: Statistically significant differences (p < 0.05) in the implant stability values obtained at surgery (T0) and at the eighth week of osseointegration (T8) were observed between the two groups, with higher values for the <4 group. Pearson’s correlation analysis revealed a trend towards a significant relationship with the mean force (−0.6546) and a linear inverse relationship, so that by decreasing the distance between the abutment and the contact with the antagonist, the secondary implant stability values increased. A comparison of the mesial and distal peri-implant marginal bone levels at T0 and T8 did not reveal statistically significant differences (p > 0.05). A greater healing abutment height, placing it closer to the antagonist, increases and accelerates secondary stability, as measured by resonance frequency analysis. Conclusions: The results of the study support the recommendation of using high healing abutments, placing the abutment close to the opposing occlusal plane, according to biomechanical criteria. Full article

To improve implant osseointegration while preventing infection, we developed a strontium (Sr)-doped Ti₃C₂T_x MXene coating on titanium, aiming to synergistically enhance bone integration and antibacterial performance. MXene is a family of two-dimensional transition-metal carbides/nitrides whose abundant surface terminations endow high hydrophilicity and bioactivity. The coating was fabricated via anodic electrophoretic deposition (40 V, 2 min) of Ti₃C₂T_x nanosheets, followed by SrCl₂ immersion to incorporate Sr²⁺. The coating morphology, phase composition, chemistry, hydrophilicity, mechanical stability, and Sr²⁺ release were characterized. In vitro bioactivity was assessed with rat bone marrow mesenchymal stem cells (BMSCs)—with respect to viability, proliferation, migration, alkaline phosphatase (ALP) staining, and Alizarin Red S mineralization—while the antibacterial efficacy was evaluated against Staphylococcus aureus (S. aureus) via live/dead staining, colony-forming-unit enumeration, and AlamarBlue assays. The Sr-doped MXene coating formed a uniform lamellar structure, lowered the water-contact angle to ~69°, and sustained Sr²⁺ release (0.36–1.37 ppm). Compared to undoped MXene, MXene/Sr enhanced BMSC proliferation on day 5, migration by 51%, ALP activity and mineralization by 47%, and reduced S. aureus viability by 49% within 24 h. Greater BMSCs activity accelerates early bone integration, whereas rapid bacterial suppression mitigates peri-implant infection—two critical requirements for implant success. Sr-doped Ti₃C₂T_x MXene thus offers a simple, dual-function surface-engineering strategy for dental and orthopedic implants. Full article

Objectives: In the animal model, we aim to evaluate the bone behavior in two innovative and different laser-treated (L1–L2) titanium implants compared to sandblasted and acid-etched (SBAE) used as control. Materials and Methods: A total of twenty-seven dental implants (8.5 × 3.3 mm) used for the study (Sweden & Martina, Due Carraie Padova-Italy) were placed in three Pelibuey female sheep. Implant surface profilometric, contact angle and EDX analysis were detected. After 15, 30 and 90 days, histological, histomorphometric, SEM-EDX analysis and Bone-to-implant Contact (BIC), Dynamic Osseointegration Index (DOI) and Bone Quality Index (BQI) (as Calcium and Phosphorous atomic percentages ratio) were performed. Results: All surfaces showed relevant profilometric and wettability differences. After 15 days, BIC₁₅ showed great differences in L2 (42.1 ± 2.6) compared to L1 (5.2 ± 3.1) and SBAE (23.3 ± 3.9) as well as after 30 days (L2 (82.4 ± 2.2), L1 (56.2 ± 1.3) and SBAE (77.3 ± 0.4)). After 90 days, relevant lower BIC₉₀ values were detected in L1 (68.4 ± 0.2) compared to L2 (86.4 ± 0.1) and SBAE (86.2 ± 0.6). The DOI showed higher rates of bone growth in L2 after 15 (DOI₁₅ = 2.81) and 30 days (DOI₃₀ = 2.83), compared to L1 (DOI₁₅ = 0.38, DOI₃₀ = 3.40) and SBAE (DOI₁₅ = 1.55, DOI₃₀ = 2.58). The DOI₉₀ drastic slowdown in SBAE (0.96), L1 (0.76), and L2 (0.95) confirmed the Early Osseointegration (EO) as a crucial phase. Moreover, before loading, the lower global BQI in L1 (Ca 44.43 ± 0.08–P 46.14 ± 5.15) and SBAE (Ca 45.31 ± 2.08–P 48.28 ± 1.12) compared to L2 (Ca 79.81 ± 2.08–P 81.85 ± 3.14) allows to assert that osseointegration process and bone healing could not be considered complete if compared to the native bone. Conclusions: The BIC, DOI, and BQI results showed that osseointegration is a dynamic process, confirming the crucial role of surface characteristics able to influence it, especially the early osseointegration (EO) phase. The short-time L2 implants’ higher bone quantity and quality results, compared to L1 and SBAE, suggested the fundamental role of this innovative laser-obtained surface in “secondary stability” and predictable long-term clinical outcomes. Full article

The biological aging of titanium implants, marked by increased surface hydrophobicity and organic contamination, reduces bioactivity and delays osseointegration. A major challenge in implant dentistry is determining how to preserve surface hydrophilicity during storage, as conventional atmospheric conditions accelerate surface degradation. This pilot in vivo study aimed to evaluate ozone nanobubble water (NBW3) as a storage medium to prevent biological aging and enhance the early-stage osseointegration of glow discharge-treated titanium implants. Screw-type implants were stored in either NBW3 or atmospheric conditions and then implanted into femoral bone defects in Sprague Dawley rats. Removal torque testing, scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), and histological analysis of bone-to-implant contact (BIC) were performed 14 and 28 days post-implantation. At 14 days, the NBW3-stored implants demonstrated significantly higher removal torque (2.08 ± 0.12 vs. 1.37 ± 0.20 N·cm), BIC (65.74 ± 12.65% vs. 44.04 ± 14.25%), and Ca/P atomic ratio (1.20 ± 0.32 vs. 1.00 ± 0.22) than the controls. These differences were not observed at 28 days, indicating NBW3’s primary role in accelerating early osseointegration. The findings suggest that using NBW3 is a simple, effective approach to maintain implant surface bioactivity during storage, potentially improving clinical outcomes under early or immediate loading protocols. Full article

Total hip arthroplasty is one of the most common and rapidly growing surgical procedures, with over one million cases performed annually in the United States. Despite high success rates, revision surgeries remain a significant concern due to complications such as aseptic loosening, often resulting from inadequate primary implant stability. This study presents an automated computational framework that integrates three-dimensional preoperative planning and finite element modeling to predict the primary stability of hip implants. Data obtained from the virtual surgery phase are used to generate subject-specific finite element models, which are executed on high-performance computing systems. The simulation evaluates implant stability by analyzing the contact interaction between the bone and the implant. The pipeline is demonstrated using data from the open-source HFValid collection and a commercial implant. Automation substantially reduced the time required to set up simulations, improving the efficiency on high-performance infrastructure. This integrated computational approach bridges the gap between biomechanical modeling and clinical decision-making and can serve as a preclinical tool for identifying personalized implant strategies and for conducting large-scale virtual cohort studies. Full article

A varied family of polyphenolic chemicals, flavonoids, are becoming more and more important in bone tissue engineering because of their osteogenic, anti-inflammatory, and antioxidant effects. Recent developments incorporating flavonoids into different biomaterial platforms to improve bone regeneration are emphasized in this study. Osteocalcin (OCN) expression was 2.1-fold greater in scaffolds loaded with flavonoids—such as those made of polycaprolactone (PCL)—greatly increasing human mesenchymal stem cell (hMSC) proliferation and mineralization. Comparably, a threefold increase in calcium deposition indicates increased mineralization when hydroxyapatite (HA) was functionalized with flavonoids such as quercetin. These HA scaffolds with flavonoids also showed a 45% decrease in osteoclast activity, therefore promoting balanced bone remodeling. Concurrent with flavonoids like EGCG and quercetin, chitosan-based scaffolds encouraged osteogenic differentiation with increases in osteogenic markers like osteopontin (OPN) and alkaline phosphatase (ALP) expression by up to 82%. These scaffolds also showed 82% bone defect repair after six weeks in vivo, suggesting their promise in rapid bone regeneration. With an increase of up to 32% in the bone volume-to-total volume ratio (BV/TV) and 28% greater bone–implant contact (BIC), flavonoid coatings on titanium implants enhanced osteointegration in implantology. Displaying successful osteogenesis and immunomodulation, the addition of flavonoids into metal–organic frameworks (MOFs) and injectable hydrogels demonstrated a 72% increase in new bone formation in vivo. Though further research is required to confirm long-term clinical effectiveness, these findings show the great promise of flavonoid-functionalized biomaterials in bone regeneration. Full article

Background: The combination of polynucleotides and hyaluronic acid with bovine bone grafts in maxillary sinus lift procedures appears to be a promising strategy to enhance bone regeneration. This study aimed to analyze implant osseointegration, bone repair and sinus mucosa integrity using Bio-Oss^® and Hyaluronic Acid-Polynucleotide Gel (Regenfast^®) in maxillary sinus augmentation in rabbits. Methods: Sinus floor elevation was performed in 12 rabbits, with one implant placed per sinus simultaneously. In the control group, sinuses were grafted with deproteinized bovine bone mineral (Bio-Oss^®) alone; in the test group, Bio-Oss^® was combined with Regenfast^®. Two histological slides were obtained per sinus after 2 weeks (six animals) and 10 weeks (six animals): one from the grafted area alone (non-implant sites), and one from the implant site. Primary outcome variables included the percentage of newly formed bone, the extent of implant osseointegration, and the number of sinus mucosa perforations caused by contact with graft granules. Results: After 10 weeks of healing, the test group showed a significantly higher percentage of new bone formation (37.2 ± 6.7%) compared to the control group (26.8 ± 10.0%; p = 0.031); osseointegration extended to the implant apex in both groups; fewer sinus mucosa perforations were observed in the test group (n = 5) than in the control group (n = 14). Conclusions: The addition of Regenfast^® to Bio-Oss^® granules promoted enhanced bone regeneration within the elevated sinus area and was associated with a lower incidence of sinus membrane perforations compared to the use of Bio-Oss^® alone. Full article