Search Results (1,077)

Background/Objectives: Dental implant placement protocols including immediate (IIP) and delayed implant placement (DIP) are likely to affect bone tissue repair and regeneration after the surgery. Despite many benefits of IIP, it has remained unclear whether IIP demonstrates comparable healing processes and outcomes to those observed in DIP. This review aims to summarize and compare biological and clinical outcomes of IIP and DIP, focusing on success and survival rates, periodontal status, esthetics and radiographic outcomes, and biochemical markers. Methods: A literature search of electronic databases was conducted using PubMed/MEDLINE, Embase, and the Scopus databases (January 1983–February 2025). 109 articles published in English, consisting of in vitro, in vivo, and clinical studies met the inclusion criteria. Results: This review shows that both IIP and DIP show similar implant survival rates, but IIP may lead to a higher risk of mid-facial recession in esthetic areas. DIP, on the other hand, can result in better soft tissue and bone healing. Histological and radiographic evidence shows comparable bone to implant contact (BIC) between the two methods, although peri-implant bone loss tends to be higher with IIP. Lastly, although specific molecular markers are well-established in all phases of osseointegration following DIP, there is no available literature comparing differences in biomarkers during healing periods between IIP and DIP. Conclusions: This review highlights the similarities and differences in the outcomes of IIP and DIP, as well as the knowledge gaps that require further investigation, providing valuable insights for predicting treatment outcomes and managing complications associated with dental implant placement. Full article

Background: Postoperative bone healing can be impaired by systemic factors and surgical trauma, leading to delayed recovery. Photobiomodulation therapy (PBMT) has been proposed as a non-invasive method to enhance osteogenesis, but variability in protocols and outcomes limits its clinical use. Aim: To systematically review and synthesize evidence from randomized controlled trials (RCTs) evaluating PBMT’s effectiveness in promoting postoperative osteogenesis. Methods: A systematic search of PubMed, Embase, Scopus, and Cochrane Library was conducted following the PRISMA 2020 guidelines. Only RCTs comparing PBMT with sham treatment or standard care were included. Data on laser parameters, surgical indications, and outcomes such as bone regeneration, healing time, and implant stability were extracted. The risk of bias of the included randomized studies was evaluated using the Cochrane Risk of Bias 2 (RoB version 2) tool. Results: Twelve RCTs were included. PBMT consistently improved early soft tissue healing and reduced postoperative inflammation and edema. Some studies showed accelerated bone maturation, especially in grafted sockets and distraction osteogenesis, while others reported no significant long-term effects on implant stability or chronic lesion healing. Heterogeneity in laser parameters limited comparability. Conclusions: PBMT is a safe adjunct that reliably enhances early postoperative healing and may promote bone remodeling in selected cases. Standardized protocols and larger, high-quality RCTs are needed to confirm long-term benefits and optimize treatment parameters. Full article

Contemporary advances in bioengineering and materials science have substantially improved the viability of medical implants. The demand for optimized implant technologies has led to the development of advanced coatings that enhance biocompatibility, antimicrobial activity, and durability. Implant manufacturers and surgeons must anticipate both biological and mechanical challenges when implementing devices for patient use. Key areas of concern include infection, corrosion, wear, immune response, and implant rejection; regulatory and economic considerations must also be addressed. Materials science developments are optimizing the integration of established materials such as biometrics, composites, and nanomaterials, while also advancing fabrication-based innovations including plasma functionalization, anodization, and self-assembled monolayers. Emerging smart and stimuli-responsive surface technologies enable controlled drug delivery and real-time implant status communication. These innovations enhance osseointegration, antimicrobial performance, and overall device functionality across orthopedic, dental, and cardiovascular applications. As implant design continues to shift toward personalized, responsive systems, advanced coating technologies are poised to deliver significantly improved long-term clinical outcomes for patients. Full article

Background and Objectives: Short femoral stems are increasingly used in total hip arthroplasty (THA), yet evidence regarding their performance in elderly femoral neck fracture (FNF) patients is limited. In this study, we compared clinical and radiographic outcomes of the use of a short femoral stem (SFS) versus a conventional standard stem (CSS) in cementless THA. Materials and Methods: This prospective, single-center case–control study (1:2) included patients ≥ 65 years of age with displaced FNF (Garden 3–4) treated with cementless THA. Follow-up lasted a minimum of 2 years. Clinical evaluations included the Harris Hip Score (HHS), Roles and Maudsley satisfaction score, and thigh pain assessment. Radiographic evaluations assessed cup position, osseointegration (Moore signs), radiolucencies (DeLee–Charnley and Gruen zones), subsidence, leg length discrepancy (LLD), and heterotopic ossification. Results: A total of 114 patients were analyzed (38 with SFS versus 76 with CSS). The final follow-up HHS was 87 ± 2.7 (SFS) and 88 ± 2.5 (CSS) (p = 0.231), and satisfaction was excellent in nearly all patients in both groups. Thigh pain was rare and resolved by final follow-up in all SFS patients, and no radiographic loosening was observed. Early subsidence (≤3 mm) occurred in two SFSs and three CSSs without progression, while LLD < 1 cm was present in three SFS and eight CSS cases. No implant-related revisions occurred, and complication rates were low and comparable. Conclusions: Short femoral stems provided clinical and radiographic outcomes equivalent to those of conventional stems in elderly FNF patients treated with cementless THA. Short stems appear to be a safe and effective option in this population, and further studies with longer follow-up are needed to confirm their durability. Full article

Additive manufacturing (AM) has emerged as a key enabling technology in contemporary dental manufacturing, driven by its capacity for customization, geometric complexity, and seamless integration with digital design workflows. This article presents a technology-oriented narrative review of additive manufacturing in dental implant production, focusing on dominant processing routes, material systems, and emerging research trends rather than a systematic or critical appraisal of the literature. An indicative descriptive analysis of publications indexed in the Web of Science and Scopus databases between 2014 and 2024 was used to contextualize the technological development of the field and identify major research directions. Emphasis was placed on metal powder bed fusion technologies, specifically Selective Laser Melting (SLM) and Direct Metal Laser Sintering (DMLS), which enable the fabrication of titanium implants with controlled porosity and enhanced osseointegration. Ceramic AM approaches, including SLA, DLP, and PBF, are discussed in relation to their potential for aesthetic dental restorations and customized prosthetic components. The publication trend overview indicates a growing interest in ceramic AM after 2020, an increasing focus on hybrid and functionally graded materials, and persistent challenges related to standardization and the availability of long-term clinical evidence. Key technological limitations—including manufacturing accuracy, material stability, validated metrology, and process reproducibility—are highlighted alongside emerging directions such as artificial intelligence-assisted workflows, nanostructured surface modifications, and concepts enabling accelerated or immediate clinical use of additively manufactured dental restorations. Full article

Early oxidative stress caused by titanium implants can impair osseointegration. Manganese dioxide (MnO₂) nanozyme coatings have the potential to scavenge H₂O₂ and simultaneously generate O₂ to alleviate hypoxia, but their activity is mostly static, and the ion release is detrimental. A nano-MnO₂/Ti/P(VDF-TrFE) sandwich-structured composite was fabricated, and ferroelectric polarization was applied to preset a tunable surface potential. Kelvin probe force microscopy (KPFM) verified a presettable potential within ±500 mV. Steady-state kinetics confirmed an enhancement in overall catalytic efficiency (higher V_max and lower K_m). This translated to a faster initial decomposition rate at a low, physiologically relevant H₂O₂ concentration (300 μM). Correspondingly, under these oxidative stress conditions, cell survival in the polarized group was higher than that in the unpolarized group, indicating that the enhanced initial rate can have a positive effect in such conditions. Overall, this study demonstrates a proof-of-concept strategy to tune MnO₂ nanozyme catalysis using a polarization-preset surface potential, targeting implantation-relevant ROS-rich conditions. Full article

Background/Objectives: Orthopaedic infections associated with implant surgery remain a major public health concern, often caused by bacterial colonization of implant surfaces. Staphylococcus epidermidis is among the most common pathogens involved. Developing antimicrobial bone implants that prevent infection without compromising bone regeneration is therefore essential. This study investigates the antimicrobial and osteointegrative performance of calcium phosphate (CaP) materials functionalized with vanillin, an essential oil component with known antimicrobial properties. Methods: Commercial CaP regenerative materials were covalently coated with vanillin. Antibacterial activity was evaluated against Staphylococcus epidermidis RP62A using viability assays. In vivo osseointegration was assessed in New Zealand female rabbits implanted with vanillin-coated and uncoated CaP scaffolds. Results: Vanillin-functionalized CaP scaffolds exhibited strong bactericidal activity at 24 h and bacteriostatic effects at 48 h at a concentration of 10 mg/mL. In vivo analyses showed no significant differences in osseointegration between vanillin-coated implants and control CaP materials. Conclusions: Vanillin-functionalized CaP materials maintain a high safety profile without impairing bone integration, supporting their potential use in clinical applications. Full article

This study evaluated the surface functionalization of a non-equiatomic TiZrNbTaMo high-entropy alloy (HEA) by micro-arc oxidation (MAO) in Cu-rich electrolytes to tailor its performance for biomedical implants. The Cu content was varied, and the resulting coatings were investigated for their morphology, phase constitution, chemical structure, wettability, and cytocompatibility. X-ray diffraction (XRD) measurements of the substrate indicated a body-centered cubic (BCC) matrix with minor HCP features, while the MAO-treated samples depicted amorphous halo with sparse reflections assignable to CaCO₃, CaO, and CaPO₄. Chemical spectroscopic analyses identified the presence of stable oxides (TiO₂, ZrO₂, Nb₂O₅, Ta₂O₅, MoO₃) and the successful incorporation of bioactive elements (Ca, P, Mg) together with traces of Cu, mainly as Cu₂O. MAO treatment increased surface roughness and rendered a hydrophilic behavior, which are features typically favorable to osseointegration process. In vitro cytotoxic assays with MC3T3-E1 cells (24 h) showed that Cu addition did not induce harmful effects, maintaining or improving cell viability and adhesion compared to the controls. Collectively, MAO in Cu-rich electrolyte yielded porous, bioactive, and Cu-incorporated oxide coatings on TiZrNbTaMo HEA, preserving cytocompatibility and supporting their potential for biomedical applications like orthopedic implants and bone-fixation devices. Full article

Zinc and its alloys have been regarded as an alternative option for biodegradable implant materials to magnesium and iron-based alloys due to their promising degradation rate. However, poor osseointegration with bone tissue limits their further clinical application. Considering the biofunction of strontium (Sr), namely promoting the formation of bone tissue, in this work, a ZnO-Sr composite coating was prepared on pure Zn via anodic oxidation to boost bioactivity. Surface morphology and composition of the layer were examined via scanning electron microscopy (SEM) and X-ray diffraction (XRD). Electrochemical measurements were carried out to assess the corrosion behaviour. Long-term immersion tests in simulated body fluid (SBF) for up to 21 days were conducted to evaluate the in vitro bioactivity. Corrosion morphology and corrosion products were studied to reveal the corrosion mechanism. The results demonstrated that the Sr-ZnO coating optimized the corrosion rate and enhanced the bioactivity of the substrate, improving its potential for orthopedic applications. Full article

Background and Objectives: The insertion of endosseous implants requires the alveolar bone to be drilled, which produces alterations of the osseous neoalveolus approximately 1 mm deep, an area that will later be subjected to osseous renewal. The healing of the bone around the inserted implant is complex and depends on numerous factors, amongst which the size of the insertion orifice relative to the diameter of the implant, the design, and the pace and depth of the threads play an essential part. Therefore, the aim of this paper is to investigate from a histologic point of view the osseointegration of the implants inserted in a rabbit cortical bone by creating a 150 µm high healing chamber. Materials and Methods: 5 mm-long and 2 mm-wide titan implants were inserted into the femur of 15 12-month-old rabbits by using a drill with a 1.8 mm diameter, obtaining a spiralled healing chamber 150 µm high. The animals were euthanized after 7, 14, and 28 days according to effective legal and ethical protocols. The bone around the implants was severed 5 µm thick. After coloring with the Tricrom Goldner method, the sections that intercepted most centrally the intervention area were examined and photographed with an Olympus microscope. Results: The histologic result showed osseous healing within the healing chamber in the third to the endosteum of the implant after 7 days from the insertion. After 14 days, the osseous healing spread to 2/3 of the healing chamber. After 28 days, the whole healing chamber was occupied by bone. Conclusions: The healing chamber favored proper conditions for osseous healing, which began at the level of the endosteum. This statement is based on the histologic findings of bone formation after 7 days only in the third of the endosteum of the healing chamber. A 150 µm height of the healing chamber obtained in the rabbit cortical bone does not pose a risk of connective tissue proliferation. Full article

Background: Osseointegration is the main factor that ensures the long-term success of implant-prosthetic therapy, but besides this, there are other important factors, such as the quality of the alveolar bone and the time of placement of dental implants. The study aimed to analyze changes in the alveolar bone following tooth extraction, comparing natural healing with immediate implant placement, using fractal analysis on OPG images. Methods: This retrospective study included OPG images obtained before tooth extraction and 3 months after surgery in 91 patients who underwent maxillary and mandibular molar extractions and opted for either natural healing or immediate dental implant placement. Fractal analysis of OPG images was performed using Image J software, and the resulting measurements were subsequently statistically analyzed. Results: Most extractions were performed in the maxilla, and most were at the level of the first molar. The study group showed a faster healing process following immediate placement of dental implants, regardless of location, and a similar distribution of bone resorption and healing, with clear differences in location: the mandible had a faster healing process than the maxilla. Conclusions: Fractal analysis showed a better and quicker bone healing of the alveolar bone in immediate implant placement in molar areas compared with post-extraction natural healing, especially in the lower jaw. Full article

Background: Postoperative infections remain a major complication in spinal surgeries involving intersomatic screws, often compromising osseointegration and long-term implant stability. Questions/Purposes: This study evaluated a nanotextured titanium oxide surface with nanopillar-like morphology designed to reduce bacterial colonization while preserving mechanical integrity and promoting bone integration. Methods: Ti₆Al₄V screws were studied in three batches: control, passivated with HCl and acid mixture treatment to obtain nanotopographies on the surfaces. To create the nanotopographies, the screws were treated with a 1:1 (v/v) sulfuric acid–hydrogen peroxide solution for 2 h. Surface morphology, roughness, wettability, and surface energy were analyzed by SEM, confocal microscopy, and contact angle measurements. Corrosion and ion release were assessed electrochemically and by ICP-MS, respectively. Mechanical behavior, cytocompatibility, mineralization, and antibacterial efficacy were evaluated in vitro. Osseointegration was analyzed in rabbit tibiae after 21 days by histology and bone–implant contact (BIC). Results: The treatment produced uniform nanopillars (Ra = 0.12 µm) with increased hydrophilicity (49° vs. 102° control) and higher surface energy. Mechanical properties and fatigue resistance (~600 N, 10 million cycles) were unaffected. Corrosion currents and Ti ion release remained low. Nanopillar surfaces enhanced osteoblast adhesion and mineralization and reduced bacterial viability by >60% for most strains. In vivo, Bone Index Contact (BIC) was higher for nanopillars (52.0%) than for HCl-treated (43.8%) and control (40.1%) screws, showing a positive osseointegration trend (p > 0.005). Conclusions: The proposed acid-etching process generates a stable, scalable nanotopography with promising antibacterial and osteogenic potential while maintaining the alloy’s mechanical and chemical integrity. Clinical relevance: This simple, scalable, and drug-free surface modification offers a promising approach to reduce postoperative infections and promote bone integration in spinal implants. Full article

Background/Objectives: Hydroxyapatite (HAp)-based implants and HAp–titanium (HApTi) composites are widely used in orthopedic and dental applications, but their long-term success is limited by peri-implant bone loss. Local delivery of osteoactive molecules from implant surfaces may enhance osseointegration and reduce periprosthetic osteolysis. This study combined in silico modeling and experimental assays to compare calcium fructoborate (CaFb), sodium alendronate, and calcium alendronate as functionalization agents for HAp and HApTi implants. Methods: Molecular docking (AutoDock 4.2.6) and 100 ns molecular dynamics (MD) simulations (AMBER14 force field, SPC water model) were performed to characterize ligand–substrate interactions and to calculate binding free energies (ΔG_binding) and root mean square deviation (RMSD) values for ligand–HAp/HApTi complexes. HAp and HApTi discs obtained by powder metallurgy were subsequently functionalized by surface adsorption with CaFb or alendronate salts. The amount of adsorbed ligand was determined gravimetrically, and in vitro release profiles were quantified by HPTLC–MS for CaFb and by HPLC after FMOC derivatization for alendronates. Results: CaFb–HAp and CaFb–HApTi complexes showed the lowest binding free energies (−1.31 and −1.63 kcal/mol, respectively), indicating spontaneous and stable interactions. For HAp-based complexes, the mean ligand RMSD values over 100 ns were 0.27 ± 0.17 nm for sodium alendronate, 0.72 ± 0.28 nm for calcium alendronate (range 0.35–1.10 nm), and 0.21 ± 0.19 nm for CaFb (range 0.15–0.40 nm). For HApTi-based complexes, the corresponding RMSD values were 0.30 ± 0.15 nm for sodium alendronate, 0.72 ± 0.38 nm for calcium alendronate and 0.26 ± 0.14 nm for CaFb. These distributions indicate that CaFb and sodium alendronate maintain relatively stable binding poses, whereas calcium alendronate shows larger conformational fluctuations, consistent with its less favorable binding energies. Experimentally, CaFb exhibited the greatest chemisorbed amount and percentage on both HAp and HApTi, followed by sodium and calcium alendronate. HApTi supported higher loadings than HAp for all ligands. Release studies demonstrated a pronounced burst and rapid plateau for both alendronate salts, whereas CaFb displayed a slower initial release followed by a prolonged, quasi-linear liberation over 14 days. Conclusions: The convergence between in silico and adsorption–release data highlights CaFb as the most promising candidate among the tested ligands for long-term functionalization of HAp and HApTi surfaces. Its stronger and more stable binding, higher loading capacity and more sustained release profile suggest that CaFb-coated HApTi implants may provide a favorable basis for future in vitro and in vivo studies aimed at improving osseointegration and mitigating periprosthetic osteolysis, although direct evidence for osteolysis prevention was not obtained in the present work. Full article

Osseointegration in dental implants involves the use of materials that mimic the bone tissue, with special properties such as biocompatibility and biodegradability. In this study, we describe the preparation and characterization of composites based on collagen, chondroitin sulfate, and sage oil obtained by freeze-drying method. Their morphological structures were determined by water uptake and scanning electron microscopy, the physical–chemical interactions between components by FT-IR, the stability by in vitro collagenase degradation, and the results indicate that the samples’ properties are highly influenced by the hydrophobic and hydrophilic character of sage essential oil and chondroitin sulfate, respectively, concluding that we can design a formulation with certain properties. The composite spongious forms were evaluated for cytocompatibility using the MG63 osteoblast cell line and subjected to histological observation. The results showed that the samples with sage essential oil were most resistant to enzymatic degradation, and the ones with chondroitin sulfate promoted the deposition of an abundant extracellular matrix. Taken together, the results suggest that incorporating chondroitin sulfate and sage oil in a controlled manner into collagen scaffolds represents a promising approach for enhancing bone tissue regeneration. Full article

Background. Implant dentistry is an important treatment option for patients requiring prosthetic rehabilitation after tooth loss. This study reports the evaluation of immediately loaded, immediately placed implants in fresh extraction sockets. Methods. Fifty-two partially edentulous patients (27 females and 25 males with mean age of 53.6 years), were treated with 112 Galimplant^® implants placed immediately into fresh sockets for prosthodontic rehabilitation. All implants were loaded immediately. Clinical and radiographic parameters related to both the implants and the prosthodontic restorations were followed for 10 years. Results. Nine patients (17.3%) had a history of periodontitis, 26.9% were smokers, and 21.1% presented with chronic systemic conditions. The outcomes demonstrated an implant survival and success rate of 97.1%, indicating that immediately placed implants with immediate loading can achieve and maintain successful osseointegration. Three implants were lost during the healing period. The mean marginal bone loss was 1.09 ± 0.75 mm. Mucositis affected 21.4% of implants, and peri-implantitis was observed in 11.6% of implants. Fourteen implants (7.1%) were associated with technical complications, including screw loosening and ceramic chipping. Conclusions. The clinical findings of this study indicate favorable long-term outcomes for immediately loaded implants placed in fresh extraction sockets. Both implants and prosthetic restorations demonstrated a success rate of over 92.9% during the observation period. Full article