Search Results (843)

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

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/Objectives: Dental practitioners widely use dental implants to treat traumatic cases. Titanium implants are currently the most popular choice among dental practitioners and surgeons. The discovery of newer polymeric materials is also influencing the interest of dental professionals in alternative options. A comparative study between existing titanium implants and newer polymeric materials can enhance professionals’ ability to select the most suitable implant for a patient’s treatment. This study aimed to investigate material property advantages of high-performance thermoplastic biopolymers such as PEEK and PEKK, as compared to the time-tested titanium implants, and to find the most suitable and economically fit implant material. Methods: Three distinct implant material properties were assigned—PEEK, PEKK, and commercially pure titanium (CP Ti-55)—to dental implants measuring 5.5 mm by 9 mm, along with two distinct titanium (TI6AL4V) abutments. Twelve three-dimensional (3D) models of bone blocks, representing the mandibular right molar area with Osseo-integrated implants were created. The implant, abutment, and screw were assumed to be linear; elastic, isotropic, and orthotropic properties were attributed to the cancellous and cortical bone. Twelve model sets underwent a three-dimensional finite element analysis to evaluate von Mises stress and total deformation under 250 N vertical and oblique (30 degree) loads on the top surface of each abutment. Results: The study revealed that the time-tested titanium implant outperforms PEEK and PEKK in terms of marginal bone preservation, while PEEK outperforms PEKK. Conclusions: This study will assist dental practitioners in selecting implants from a variety of available materials and will aid researchers in their future research. Full article

Background/Objectives: The growing demand for biocompatible and fluoride-free alternatives in oral care has led to the development of formulations containing nano-hydroxyapatite (nanoHAP). This study aimed to evaluate the antimicrobial, antibiofilm, antioxidant, and anti-inflammatory properties of a novel mouthwash containing nanoHAP, zinc lactate, D-panthenol, licorice extract, and cetylpyridinium chloride, with particular focus on its efficacy against Staphylococcus aureus and its biofilm on various dental materials. Methods: The antimicrobial activities of the mouthwash KWT0000 and control product ELM were assessed via minimal inhibitory concentration (MIC) testing against selected Gram-positive and Gram-negative bacteria and Candida fungi. Antibiofilm activity was evaluated using fluorescence and digital microscopy following 1-h exposure to biofilms of Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans. The efficacy was compared across multiple dental materials, including titanium, zirconia, and PMMA. Antioxidant capacity was determined using the 2,2-diphenyl-1-picrylhydrazyl radical (DPPH) assay, and anti-inflammatory potential via hyaluronidase inhibition. Results: KWT0000 exhibited strong antimicrobial activity against S. aureus and C. albicans (MICs: 0.2–1.6%) and moderate activity against Gram-negative strains. Fluorescence imaging revealed significant biofilm disruption and bacterial death after 1 h. On metallic surfaces, especially polished titanium and zirconia, KWT0000 reduced S. aureus biofilm density considerably. The formulation also demonstrated superior antioxidant (55.33 ± 3.34%) and anti-inflammatory (23.33 ± 3.67%) activity compared to a fluoride-based comparator. Conclusions: The tested nanoHAP-based mouthwash shows promising potential in antimicrobial and antibiofilm oral care, particularly for patients with dental implants. Its multifunctional effects may support not only plaque control but also soft tissue health. Full article

This study investigates the surface modification of Ti-6Al-4V alloy through the electrical discharge machining (EDM) process to improve its suitability for orthopedic and dental implant applications. The analysis focused on evaluating the morphological, wettability, roughness, hardness, and biocompatibility properties of the modified surfaces. Samples were subjected to different dielectric fluids and polarities during EDM. Subsequently, optical microscopy, roughness measurements, Vickers microhardness, contact angle tests, and in vitro cytotoxicity assays were performed. The results demonstrated that EDM processing led to the formation of distinct layers on the sample surfaces, with surface roughness increasing under negative polarity by up to ~304% in Ra and 305% in Rz. Additionally, wettability measurements indicated that the modified surfaces presented a lower water contact angle, which suggests enhanced hydrophilicity. Moreover, the modified samples showed a significant increase in Vickers microhardness, with the highest value reaching 1520 HV in the recast layer, indicating improvements in the mechanical properties. According to ISO 10993-5, all treated samples were classified as non-cytotoxic, presenting RGR values above 75%, similar to the untreated Ti-6Al-4V alloy. Therefore, it is concluded that surface modification through the EDM process has the potential to enhance the properties and safety of biomedical implants made with this alloy. Full article

Titanium (Ti) alloys, renowned for their exceptional physicochemical properties and high biocompatibility, are widely utilized in orthopedic and dental implants; however, their lack of intrinsic antimicrobial activity significantly increases the risk of implant-associated infections, often leading to severe complications and implant failure. Developing antimicrobial coatings on Ti implants is therefore a promising strategy. In this study, tannic acid (TA) coatings were deposited by immersing Ti alloy surfaces—beforehand activated by low-temperature oxygen plasma—in TA solutions at 2, 5, and 8 wt%. Coatings were characterized by scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), water contact angle (WCA) measurements, and Folin–Ciocalteu release assays, and their cytocompatibility and antimicrobial performance were assessed in vitro. Surface characterization confirmed the formation of uniform TA layers, and WCA measurements indicated enhanced hydrophilicity relative to unmodified Ti (82.0° ± 3.6°), with values decreasing as TA concentration increased (from 35.2° ± 3.2° for 2% TA to 26.6° ± 2.8° for 8% TA). TA release profiles exhibited an initial burst followed by sustained diffusion, with 5% and 8% coatings releasing significantly more TA than 2% coatings. Coatings containing ≥ 5% TA demonstrated bactericidal activity—achieving > 2-log₁₀ reductions—against Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa, and also showed inhibitory effects against Candida albicans. Importantly, all coatings remained cytocompatible with NIH/3T3 fibroblasts, and the released tannic acid hydrolysis products (particularly gallic acid) enhanced their proliferation. These findings indicate that plasma-activated titanium surfaces coated with ≥5 wt% tannic acid impart broad-spectrum antimicrobial efficacy and hold potential to reduce implant-associated infections and improve long-term outcomes in orthopedic and dental applications. Full article

Background and Clinical Significance: The retreatment of failed dental implants remains a challenging clinical scenario, particularly when complicated by peri-implantitis and as sociated bone loss. Successful management requires a comprehensive and predictable approach that addresses both hard and soft tissue deficiencies. Case Presentation: This case report illustrates a fully digital, prosthetically driven workflow for the rehabilitation of a posterior mandibular site following implant failure. A 44-year-old female patient underwent removal of a failing implant and adjacent tooth due to advanced peri-implantitis and periodontitis. After healing, a digital workflow—including intraoral scanning, cone-beam computed tomography (CBCT), and virtual planning—was employed to design and fabricate a customized CAD/CAM titanium mesh for vertical guided bone regeneration. The grafting procedure utilized a composite mixture of autogenous bone and anorganic bovine bone (A-Oss). After nine months of healing, two implants with a hydrophilic surface (SOI) were placed using a fully guided surgical protocol (OneGuide system). Subsequent soft tissue grafting and final prosthetic rehabilitation with monolithic zirconia restorations resulted in stable functional and aesthetic outcomes. Conclusions: This case highlights how the integration of modern digital technologies with advanced regenerative procedures and innovative implant surfaces can enhance the predictability and long-term success of implant retreatment in compromised posterior sites. Full article

Hydroxyapatite (HA) has become a widely used material for bone grafting and surface modification of titanium-based orthopedic implants due to its excellent biocompatibility. Among various coating techniques, microplasma spraying (MPS) has gained significant industrial relevance. However, the clinical success of HA coatings also depends on their adhesion to the implant substrate. Achieving durable fixation and reliable biological integration of orthopedic implants remains a major challenge due to insufficient coating adhesion and limited osseointegration. This study addresses challenges in dental and orthopedic implantology by evaluating the microstructure, mechanical properties, and biological behavior of bilayer coatings composed of a zirconium (Zr) sublayer and an HA top layer, applied via MPS onto titanium alloy. Surface roughness, porosity, and adhesion were characterized, and pull-off and shear tests were used to assess mechanical performance. In vitro biocompatibility was tested using rat mesenchymal stem cells (MSCs) to model osteointegration. The results showed that the MPS-fabricated Zr–HA bilayer coatings achieved a pull-off strength of 28.0 ± 4.2 MPa and a shear strength of 32.3 ± 3.2 MPa, exceeding standard requirements. Biologically, the HA top layer promoted a 45% increase in MSC proliferation over three days compared to the uncoated titanium substrate. Antibacterial testing also revealed suppression of E. coli growth after 14 h. These findings support the potential of MPS-applied Zr-HA coatings to enhance both the mechanical integrity and biological performance of titanium-based orthopedic implants. 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

Background/Objectives:Titanium implant surface modifications enhance osseointegration and prevent microbial colonization, improving implant longevity. Antimicrobial coatings, particularly cerium- and bismuth-doped hydroxyapatite (CeHAp and BiHAp), have gained attention for reducing infection-related complications. This study evaluates the antimicrobial activity of CeHAp and BiHAp coatings on CpTi compared to untreated CpTi in artificial saliva at pH levels of 4.5, 6.5, and 8. Methods: Antibacterial efficacy against Staphylococcus aureus (S. aureus), Escherichia coli (E. coli), and Candida albicans (C. albicans) was assessed using the broth dilution method. Titanium rods coated with test compounds were incubated in inoculated nutrient broth, and microbial inhibition was determined via optical density at 600 nm. A statistical analysis was performed using the Kruskal–Wallis ANOVA test, the median and Interquartile Range were determined for the variables, and a Dwass–Steel–Critchlow–Fligner intergroup pairwise comparison was conducted. Results: The results showed that both the CeHAp and BiHAp coatings demonstrated significant antimicrobial activity against S. aureus (OD = 0.01) at pH 6.5, which was more pronounced than the activity observed against E. coli (OD = 0.05), with the difference being statistically significant (p = 0.001). The least antimicrobial activity was observed against C. albicans (0.21) at pH 8 (p = 0.001). Conclusion: These findings highlight the pH-dependent effectiveness of BiHAp and CeHAp coatings in inhibiting microbial growth. Their application on titanium implants may enhance antimicrobial properties, contributing to improved dental implant success and broader biomedical applications. Full article

Stainless steel (SS) is one of the materials most commonly utilized for fabrication of medical implants and its properties are often improved by deposition of protective coatings. This study investigates certain physico-chemical and biological properties of SS substrate coated with multilayer thin film consisting of titanium nitride and silver layers (TiN-Ag film). TiN-Ag films were deposited on the surface of AISI 316 SS substrate by a combination of cathodic arc evaporation and DC magnetron sputtering. SS substrate was analyzed by TEM, while deposited coatings were analyzed by SEM, EDS and wettability measurements. Also, mitochondrial activity assay, and osteogenic and chondrogenic differentiation were performed on dental pulp stem cells (DPSCs). SEM and EDS revealed excellent adhesion between coatings’ layers, with the top layer predominantly composed of Ag, which is responsible for antibacterial properties. TiN-Ag film exhibited moderately hydrophilic behaviour which is desirable for orthopedic implant applications. Biological assays revealed significantly higher mitochondrial activity and enhanced osteogenic and chondrogenic differentiation of DPSC on TiN-Ag films compared to TiN films. The newly designed TiN-Ag coatings showed a great potential for the surface modification of SS implants, and further detailed investigations will explore their suitability for application in clinical practice. Full article

The stability of yttria-stabilized zirconia (YSZ) as a dental implant material is highly dependent on its resistance to low-temperature degradation (LTD) and surface dissolution, particularly in acidic oral environments. This study investigates the effects of yttrium ion (Y³⁺) release on the phase stability of zirconia during constant immersion and pH cycling tests, simulating oral conditions. Zirconia disks were immersed in acidic (pH 2), neutral (pH 7), and basic (pH 10) solutions over a 27-day period. Inductively coupled plasma (ICP) analysis revealed significant yttrium ion release during acidic phases, while zirconium ion (Zr⁴⁺) release remained minimal. X-ray photoelectron spectroscopy (XPS) showed a shift in zirconium 3d binding energies, indicating a transformation from the tetragonal to the monoclinic phase, driven by yttrium leaching. X-ray diffraction (XRD) confirmed this phase change, with the appearance of the monoclinic (111) peak after exposure to acidic conditions. This study concludes that yttrium ion depletion under acidic conditions destabilizes the tetragonal phase, promoting LTD and compromising the material’s long-term performance as a dental implant or restorative material. Full article

The attachment of the oral epithelium to the abutment surface is crucial for the long-term success of dental implants. This study aimed to evaluate the attachment of human epithelial cells to anodized titanium surfaces. Anodized titanium discs were used as the experimental group, while machined titanium discs served as the control. Surface roughness and wettability were first measured for each group. Next, human epithelial cells were seeded onto each disc at a density of 4.0 × 10⁴ cells/cm² and evaluated 3, 6, and 24 h later for cell proliferation, as well as mRNA expression and protein levels of laminin and integrin β₄. Surface roughness was comparable between the two groups; however, wettability was significantly higher in the experimental group. Cell proliferation increased over time in both groups and showed no significant difference. Notably, the expression levels of both laminin and integrin β₄ were significantly higher in the experimental group at 24 h. Furthermore, protein localization of laminin and integrin β₄ was observed along the cell margins on the anodized surface. These findings suggest that anodization enhances epithelial cell attachment by promoting the expression and peripheral organization of key adhesion molecules. Full article

Background/Objectives: The infraorbital canal (IOC) is a critical anatomical structure that passes through the anterior surface of the maxilla and opens at the infraorbital foramen, containing the infraorbital nerve, artery, and vein. Accurate localization of this canal in maxillofacial, dental implant, and orbital surgeries is of great importance to preventing nerve damage, reducing complications, and enabling successful surgical planning. The aim of this study is to perform automatic segmentation of the infraorbital canal in cone-beam computed tomography (CBCT) images using an artificial intelligence (AI)-based model. Methods: A total of 220 CBCT images of the IOC from 110 patients were labeled using the 3D Slicer software (version 4.10.2; MIT, Cambridge, MA, USA). The dataset was split into training, validation, and test sets at a ratio of 8:1:1. The nnU-Net v2 architecture was applied to the training and test datasets to predict and generate appropriate algorithm weight factors. The confusion matrix was used to check the accuracy and performance of the model. As a result of the test, the Dice Coefficient (DC), Intersection over the Union (IoU), F1-score, and 95% Hausdorff distance (95% HD) metrics were calculated. Results: By testing the model, the DC, IoU, F1-score, and 95% HD metric values were found to be 0.7792, 0.6402, 0.787, and 0.7661, respectively. According to the data obtained, the receiver operating characteristic (ROC) curve was drawn, and the AUC value under the curve was determined to be 0.91. Conclusions: Accurate identification and preservation of the IOC during surgical procedures are of critical importance to maintaining a patient’s functional and sensory integrity. The findings of this study demonstrated that the IOC can be detected with high precision and accuracy using an AI-based automatic segmentation method in CBCT images. This approach has significant potential to reduce surgical risks and to enhance the safety of critical anatomical structures. Full article