Search Results (1,259)

Objective: This narrative review synthesizes current evidence on materials and manufacturing technologies for customized dental implants, highlighting their comparative advantages and limitations. Methods: A structured literature search (December 2024–January 2025) was conducted using PubMed, Web of Science, Scopus, and Google Scholar. Peer-reviewed English-language articles (mainly 2015–2025) addressing implant materials, manufacturing methods, and surface modifications were included. Data were critically analyzed and thematically organized without meta-analysis. Results: Digital workflows are advancing implantology toward patient-specific solutions. Subtractive manufacturing (SM) ensures high precision and surface quality but is limited by material waste and geometric constraints. In contrast, additive manufacturing (AM) enables complex, porous, and customized designs, though often requires post-processing. Titanium and its alloys remain the gold standard due to strength and biocompatibility, while TiZr and β-type alloys may reduce stress shielding. Zirconia offers aesthetic benefits but is brittle, whereas PEEK shows favorable elasticity but limited bioactivity. Surface modifications enhance osseointegration and long-term performance. Conclusions: Combining digital workflows with SM and AM supports development of optimized, patient-specific implants. While titanium dominates clinical use, emerging materials offer specific advantages. Further clinical validation and standardization are required. Full article

Peri-implant marginal bone stability remains a major determinant of long-term implant success, yet clinical studies report early marginal bone changes ranging from near-stable conditions in some protocols to approximately 1–2 mm during the first year in more traditional series, underscoring considerable biological variability. In the present review, a remodeling-dominant state refers to turnover-led peri-implant adaptation with limited net cortical gain, whereas modeling-driven apposition refers to uncoupled surface bone addition and cortical reinforcement. We conducted a structured narrative review of PubMed/MEDLINE, Scopus, and Web of Science for literature published between 2000 and February 2026 and qualitatively synthesized direct peri-implant evidence, craniofacial/oral non-implant evidence, and extrapolative mechanobiology from long-bone and systemic models. The available literature supports osteocyte-centered SOST/Wnt regulation as biologically plausible for peri-implant cortical adaptation; however, direct human peri-implant molecular validation remains limited. Based on this synthesis, we propose a hypothesis-generating framework in which mechanical signal profile, microenvironmental stability, and host-related factors influence the probability of transition from a remodeling-dominant to a modeling-dominant peri-implant state. This framework should therefore be interpreted as a testable conceptual model rather than a validated peri-implant mechanism. Its main value lies in organizing current evidence and defining priorities for translational studies that integrate molecular, imaging, and biomechanical endpoints. Full article

Titanium and its alloys are used in dental and orthopedic implants. However, long-term stability remains a clinical challenge. To overcome this limitation, surface modification has been investigated to improve surface properties. Our previous study demonstrated that the immobilization of secretory leukocyte protease inhibitor (SLPI) on the titanium surface promotes osteoblast adhesion, proliferation, and differentiation in vitro. The current study demonstrated the first in vivo evaluation of SLPI as a bioactive coating for medical implants. Grade 5 titanium screws were coated with 10 µg/mL of recombinant human SLPI (rhSLPI) for 24 h via simple physical adsorption, and the results were preliminarily validated via FE-SEM and ELISA. These SLPI-coated titanium screws (TiSs) were then placed in the tibia of Sprague–Dawley rats for 4 and 8 weeks. The hematological and biochemical parameters (BUN, Creatinine, AST, and Troponin I) demonstrated no acute systemic alterations within the 8-week period across all groups. Moreover, micro-computed tomography (micro-CT) and histological analysis revealed significantly higher bone volume fraction (%BV/TV) at 4 weeks compared to uncoated controls (20.64% ± 2.452% vs. 11.73% ± 0.524%). Finally, the biomechanical stability of implants, assessed using the removal torque test, showed that TiSs showed higher strength compared to Ti at both 4 and 8 weeks. In conclusion, this study represents a novel approach to transitioning rhSLPI-coated titanium evaluation from in vitro models to an in vivo rat model. rhSLPI surface functionalization enhances early-stage osseointegration and improves implant mechanical stability without acute hematological and biochemical alterations. These proof-of-concept findings suggest the potential of SLPI as a bioactive coating strategy. Full article

This study investigates the fabrication, characterization, and computational analysis of a Ti6Al4V porous scaffold for bone tissue engineering (BTE). The main objective is to address the stress-shielding effect caused by the mismatch in the mechanical properties between the scaffold and surrounding bone. An octet-truss architecture was considered to design a highly porous scaffold (with 80.5% porosity) and fabricated using selective laser melting (SLM). The scaffold was then treated with post-processing chemical etching in oxalic acid to remove surface defects and tailor topography. Scanning electron microscopy (SEM) and X-ray diffraction (XRD) revealed that etching effectively removed adhered unmelted powder particles and created a distinct micro-textured strut surface (with increased roughness) that is conducive to osseointegration. The etching process also uniformly thinned down the struts and resulted in 10% mass loss. A compression test gave the scaffold’s compliance-corrected elastic moduli of 4.54 ± 0.18 GPa (pre-etching) and 3.53 ± 0.06 GPa (post-etching). These values closely match with the stiffness of human trabecular bone reported in the literature. The experimental modulus results were validated with a finite element model that predicted 4.188 GPa, which agrees well with the experiment. Furthermore, computational fluid dynamic simulations evaluated a permeability of 8 × 10^–9 m², consistent with transport in bone-like structures. Full article

Magnesium alloys exhibit promising application prospects in medical orthopedic implants. However, their practical applications are limited by rapid corrosion, suboptimal osseointegration, and implant-related infections. Although conventional drug-eluting polymer coatings can provide various biological functions, the uncontrolled drug release often compromises long-term therapeutic efficacy. In this study, a self-healing Mg-poly(ε-caprolactone) (PCL)@OHF coating is designed and prepared on WE43 Mg by spin coating to achieve ultrasound-triggered release of osthole. OHF consists of osthole-loaded hollow mesoporous silica nanoparticles (HMSs) modified with Pluronic F127. Drug release studies show that the nanocapsules respond to ultrasound stimulation, with the cumulative release increasing from 39.94% to 75.93% after 7 days. Furthermore, the coating demonstrates intrinsic self-healing capacity upon thermal treatment at 50 °C. Electrochemical and immersion tests reveal that the composite coating provides good barrier protection for the WE43 Mg alloy, evidenced by a decrease in corrosion current density from 2.04 × 10⁻⁶ to 5.94 × 10⁻⁷ A/cm². In vitro biological assays confirm the antibacterial efficacy against Staphylococcus aureus and Escherichia coli, as well as the ability to promote osteogenic differentiation. The results reveal a surface modification strategy that combines self-healing, anticorrosion, and on-demand drug release, offering a promising approach for advanced orthopedic implants. Full article

Titanium and its alloys are widely used for orthopedic implants, but their intrinsic bioinertness may hinder osseointegration. In this study, titanium dioxide nanotube (TNT) arrays were fabricated on Ti-6Al-4V scaffolds via anodization, and their effects on the adhesion behavior of human bone marrow mesenchymal stem cells (hBMSCs) were investigated. Surface characterization showed that anodization successfully generated ordered TNT layers, increased surface roughness, enhanced protein adsorption, and induced an apparent superhydrophilic wetting response. Compared to the untreated scaffold and TNT50, the small-diameter TNT10 surface significantly promoted hBMSC adhesion and proliferation. Microscope imaging further revealed enhanced cell spreading, F-actin organization, and vinculin expression on TNT surfaces, with the most prominent focal adhesion-related staining observed in TNT10. Quantitative proteomic analysis showed that TNT10 was associated with coordinated remodeling of adhesion- and cytoskeleton-related molecular programs, including focal adhesion, cell–substrate junction, and regulation of the actin cytoskeleton. In contrast, TNT50, despite supporting obvious cytoskeletal remodeling, was more compatible with a dynamic, higher-turnover adhesion state. Overall, these findings suggest that small-diameter TNTs provide a more favorable interfacial microenvironment for stable early hBMSC adhesion on porous titanium scaffolds. Full article

Composite materials with Ti or Ti alloy reinforcement in a Zn matrix are new, promising materials with potential applications in implantology. Infiltrating zinc into the porous titanium reinforcement of a designed implant could improve its osseointegration. In this field, it is important to avoid the formation of brittle intermetallics; therefore, understanding their growth is fundamental. This work focuses on characterizing the Ti-Zn intermetallic phases at the interface of the TiAlV/Zn and Ti/Zn composites. Samples were prepared by immersing the Ti-6Al-4V or Ti bulk material in zinc melt at various temperatures. After various dwell times, the samples (pieces of Ti-6Al-4V or Ti in the molten zinc) were removed from the furnace and cooled in air. The sequence of evolution of intermetallic phases was observed to be dependent on dwell time at selected temperatures. The influences of surface treatment methods on the boundary structure were also tested. Full article

Current evidence suggests that achieving the desired level of osseointegration necessitates a hierarchical approach to implant design. This is particularly relevant for osseointegration around implant systems such as those presenting vertical decompression chambers and acid-etched surfaces which could further be augmented by non-thermal plasma (NTP) treatment. Three implant systems were compared in this study: (i) ND (GM Helix Acqua Implant; Neodent^®, Curitiba, PR, Brazil—hybrid, acid-etched thread design treated with isotonic sodium chloride solution), (ii) Sin (Epikut Plus; S.I.N. Implant System, São Paulo, Brazil—V-shaped, acid-etched thread design treated with nano-hydroxyapatite), and (iii) Mp (Maestro; Implacil De Bortoli, São Paulo, Brazil—buttress, acid-etched thread design with decompressing vertical chambers). The ND and Sin implants were used directly as supplied by the manufacturer. For the Mp implants, the manufacturer-supplied surface was subjected to supplemental acid etching with 37% hydrochloric acid followed by Argon-based NTP treatment administered with a pulsed plasma generator prior to implantation into the iliac crest of n = 12 adult female sheep. Histomorphometric analysis was conducted at 3- and 12-week post-implantation (n = 6 sheep per time point) to assess bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO). After 3 weeks in vivo, the healing chambers of all implant groups consisted predominantly of newly forming woven bone. By 12 weeks, bone maturation was observed, with the presence of remodeling sites and some areas of well-organized lamellar structures occupying the healing chambers. At both 3 and 12 weeks, the Mp implants demonstrated significantly higher BAFO values relative to ND (p = 0.015 and p = 0.008, respectively). The combination of vertical healing chambers, acid etching, and NTP treatment promoted early vascular infiltration and sustained bone deposition. Full article

Chitosan–hydroxyapatite (CS–HA) composite coatings offer a multifunctional surface modification to improve titanium implant performance, combining hydroxyapatite’s osteoconductivity with chitosan’s biocompatibility and antimicrobial properties. This review examines recent in vitro and in vivo studies, noting consistent enhancements in osteoblast adhesion, alkaline phosphatase activity, apatite formation, and bone–implant contact. Incorporation of silver, strontium, or graphene oxide can further boost antibacterial and osteogenic effects. However, variability in coating preparation, substrate treatment, and testing protocols limits reproducibility and clinical extrapolation. Standardised methodologies and extended in vivo validation are essential to advance CS–HA coatings toward reliable dental and orthopaedic applications. Full article

Titanium and its alloys are widely used in orthopedic and dental implantology for their corrosion resistance and biocompatibility supporting osseointegration; however, their usage is accompanied by release of wear debris that may induce inflammatory responses. The necessity of formation of multifunctional coatings that accelerate osseointegration and provide long-term mechanical stability of titanium implants remains highly relevant. We propose a new simple and scalable coating method based on the laser shock processing technique, with TiO₂ and SrCO₃ powder mix used as an absorption layer. Our results show that this treatment created an approximately 158.3 ± 35.8 μm thick coating consisting of a mixed SrTiO₃-TiO₂ phase. The hardness of this coating evaluated by Vickers microhardness measurements showed a hardness increase of 3.3 times compared to the initial titanium substrate. Piezoelectric force microscopy (PFM) analysis revealed the presence of a reverse piezoelectric effect in the obtained structure confirming the highly likely successful synthesis of coating impregnated with SrTiO₃. This piezoelectric coating can be readily deposited onto titanium substrates using the proposed method, enabling exploration of potential biomedical applications in future research. Full article

Background/Objectives: Photobiomodulation therapy (PBMT) is a non-invasive therapeutic modality that enhances tissue healing, modulates inflammation, and reduces pain. Despite increasing clinical use, evidence regarding PBMT in geriatric oral conditions has not been comprehensively synthesized. This systematic review aimed to evaluate the clinical efficacy and safety of PBMT in managing orofacial conditions in older adults. Methods: A systematic search of PubMed, Embase, Scopus, and Google Scholar was conducted to identify randomized controlled trials (RCTs) published between January 2000 and March 2025. Eligible studies included patients aged ≥60 years receiving PBMT for orofacial conditions. Study selection followed predefined criteria. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool, and findings were narratively synthesized. Results: Twenty-three RCTs were included. Evidence for PBMT was most frequently reported in cancer therapy-induced oral mucositis (n = 8), with consistent reductions in lesion severity and pain. Studies on burning mouth syndrome (n = 7) and hyposalivation (n = 2) generally reported improvements in symptoms, although placebo effects were noted. Fewer studies evaluated postoperative pain (n = 2), oral lichen planus (n = 1), peri-implant conditions (n = 1), and implant osseointegration (n = 2). No clinically significant adverse events were reported. However, heterogeneity in PBMT parameters and outcome measures limited comparability. Conclusions: PBMT is a safe and clinically effective adjunctive therapy for managing orofacial conditions in older adults, particularly oral mucositis. These findings support its integration into geriatric oral care. Standardized protocols and well-designed RCTs are needed to determine optimal treatment parameters and long-term effectiveness. Full article

In a previous study, we demonstrated that a novel surface treatment applied to laser-melted Ti6Al4V substrates supports osteoblast-like cell adhesion, proliferation, and the activation of early osteogenic pathways. Building on these preliminary findings, the present work aimed to further investigate the ability of the same surface to promote extracellular matrix (ECM) deposition, organization, and osteogenic maturation, which are critical events for the establishment of a stable bone–implant interface in subperiosteal dental implants. Human osteoblast-like MG-63 cells were cultured on Ti6Al4V discs subjected to different surface treatments, including a proprietary surface modification (ATcs) specifically designed for subperiosteal applications. ECM formation and maturation were evaluated through scanning electron microscopy coupled with energy-dispersive spectroscopy, immunofluorescence, and semiquantitative analyses of osteogenic markers type I collagen (COL1A1), secreted protein acidic and rich in cysteine (SPARC), and dentin matrix protein 1 (DMP1) through Western blotting. The results showed that, while all tested surfaces supported cell adhesion, the ATcs surface promoted a distinct osteogenic profile characterized by enhanced DMP1 expression, organized collagen deposition, and the formation of calcium–phosphate–rich mineralized structures. Compared to surfaces that primarily stimulated cell proliferation or early matrix production, ATcs appeared to favour progression toward late-stage osteogenic maturation and matrix mineralization. Taken together, these findings extend our previous observations and indicate that this novel surface treatment not only supports osteoblast viability and early differentiation but also promotes extracellular matrix maturation, a key prerequisite for effective osseointegration. Although further in vivo studies are required, the present data provide additional biological rationale for the use of ATcs-treated Ti6Al4V surfaces in next-generation custom-made subperiosteal implant designs. Full article

Lumbar spine disorders often require surgical intervention using medical implants to stabilize or replace damaged structures. As the prevalence of these surgeries increases due to an aging population, rigorous preclinical evaluation is critical. This narrative review aims to summarize current testing methods, identify gaps in clinical translatability, and explore the role of emerging computational technologies. Mechanical testing protocols established by the American Society for Testing and Materials (ASTM) and the International Organization for Standardization (ISO) provide essential standardized data on structural integrity but fail to replicate the complex biological interactions of the human spine. Similarly, animal models offer insights into biological responses like osseointegration but are limited by quadrupedal biomechanics and anatomical differences. Recent advancements in Artificial Intelligence (AI) and Finite Element Analysis (FEA) enable rapid, patient-specific modeling and high-throughput screening, significantly reducing the time and cost of physical testing. Future innovations include 3D-printed personalized implants, bio-responsive materials, and genetically modified animal models to bridge existing translatability gaps. In conclusion, improving the clinical success of lumbar spine implants requires an integrated framework that combines mechanical, biological, and computational approaches. This interdisciplinary collaboration is vital for developing safer and more effective treatments for patients. Full article

Background/Objectives: It remains unclear which drilling strategy is most effective for maximizing mechanical stability in low-density bone and whether high insertion torque is determinative. The aim of this in vitro study was to compare the primary stability of implants placed using different drilling protocols—conventional (CV), undersized (US), and osseodensification (OD). Three osseodensification systems—Versah burs (V), Bone Reamer Drills (WF), and Master Conical Densifiers (DSP)—were also compared. Methods: A set of 11 blocks was used for the drilling protocol comparison (CV, US, OD) and a separate set of 11 blocks was used for the osseodensification system comparison (V, WF, DSP). External-hexagon implants were inserted epicrestally. Insertion torque was measured using a torque meter, and implant stability quotients (ISQs) were assessed through resonance frequency analysis. Results: ISQ for OD was significantly higher than that for CV but statistically similar to that for US, whereas insertion torque for OD was significantly higher than that for both US and CV. A weak correlation was found between variables for CV and US, and a moderate one was observed for OD. Both WF and DSP showed significantly higher ISQ values than V. Insertion torque for DSP was significantly higher than that for both WF and V. A moderate correlation was found between variables for DSP and V, and a weak one for WF. Conclusions: In this invitro study, the OD protocol performed better than CV in terms of ISQ and better than both CV and US in terms of insertion torque. WF and DSP outperformed V in ISQ, whereas DSP yielded the highest insertion torque. Weak-to-moderate correlations between variables in both analyses indicated that higher insertion torque did not necessarily translate into greater stability. Full article

Titanium implants are widely used in orthopedic and dental fields but often face challenges such as insufficient osseointegration and peri-implant inflammation. While Strontium (Sr) possesses potent bioactive properties, achieving its controlled delivery at the implant-tissue interface remains technically challenging. To address this, we engineered a multidimensional composite coating by constructing a micro/nano-porous TiO₂ substrate via micro-arc oxidation (MAO), followed by polydopamine (PDA)-assisted Sr immobilization. This integrated architecture significantly enhanced surface hydrophilicity and facilitated high-content Sr loading with sustained release kinetics. Biological evaluations demonstrated that the PDA-mediated interface promoted superior initial adhesion and spreading of bone marrow mesenchymal stem cells (BMSCs), synergizing with released Sr²⁺ to markedly upregulate core osteogenic markers (Runx2, ALP). Crucially, the functionalized surface actively optimized the immune microenvironment by inducing M1-to-M2 macrophage polarization and comprehensively suppressing RANKL-induced osteoclastogenesis via the downregulation of TRAP and DC-STAMP. By integrating these pro-osteogenic, anti-inflammatory, and anti-resorptive capabilities, this tri-functional system effectively rebalances the bone remodeling microenvironment. Consequently, it provides a robust, universally applicable strategy for enhancing the therapeutic efficacy of next-generation orthopedic and dental implants. Full article