Search Results (768)

Background: Soft tissue stability around dental implant abutments is critical for maintaining a functional peri-implant seal. Yellow anodization is used to improve the aesthetic and surface characteristics of titanium abutments, yet its epithelial effects under more physiologically relevant 3D conditions remain insufficiently explored. Objective: To develop a 3D bioprinted in vitro peri-implant mucosa model and to compare epithelial cell responses on yellow anodized versus turned titanium abutment surfaces. Methods: Commercial Grade 5 (Ti6Al4V) titanium abutments were anodized and compared with turned controls. A collagen-based 3D bioprinted “collar-like” construct incorporating YD-38 epithelial cells was fabricated using a custom holder system to simulate peri-implant mucosal contact. Samples were cultured for 14 and 21 days. Cell distribution and morphology were assessed by optical microscopy and HE staining, while cytoskeletal organization was evaluated by TRITC-phalloidin/Hoechst staining and confocal microscopy. Quantitative fluorescence analysis was performed at 21 days. Results: Both surfaces supported epithelial coverage in the 3D environment. Anodized specimens showed more pronounced actin cytoskeletal organization and the presence of actin-rich, filamentous cellular extensions compared with turned controls. Quantitative image analysis demonstrated significantly higher TRITC-phalloidin signal intensity at 21 days on anodized samples (p < 0.001). Conclusions: Within the limitations of a 3D epithelial in vitro model using YD-38 cells, yellow anodization was associated with enhanced epithelial cytoskeletal organization compared with turned titanium. The presented 3D bioprinted platform may serve as a practical in vitro tool for screening abutment surface modifications relevant to peri-implant soft tissue integration. Full article

Background/Objectives: Peri-implantitis is a chronic inflammatory condition affecting tissues surrounding dental implants and is characterized by progressive marginal bone loss that can ultimately lead to implant failure. Reduced vascularization and impaired immune clearance in peri-implant tissues contribute to persistent inflammation and limited therapeutic efficacy. MicroRNAs (miRNAs), particularly miR-21, have emerged as key regulators of inflammatory responses and bone remodeling. The objective of this study was to develop a bioactive dental implant coating capable of locally delivering miR-21 to modulate inflammation and promote peri-implant tissue regeneration, thereby preventing peri-implantitis. Methods: Cationic nanoparticles were synthesized using lecithin and low-molecular-weight polyethylenimine (PEI) as a non-viral delivery system for miR-21. Lecithin was employed to enhance biocompatibility, while PEI functionalization provided a positive surface charge to improve miRNA complexation and cellular uptake. The resulting lecithin–PEI nanoparticles (LEC–PEI NPs) were incorporated into a chitosan-based coating and applied to titanium implant surfaces to obtain a sustained miR-21–releasing system (miR21-implant). Transfection efficiency and biological activity were evaluated in human periodontal ligament fibroblasts (hPDLFs) and compared with a commercial transfection reagent (Lipofectamine). Release kinetics and long-term activity of miR-21 from the coating were also assessed. Results: MiR-21-loaded LEC–PEI nanoparticles demonstrated significantly higher transfection efficiency than Lipofectamine and retained marked biological activity in hPDLFs relevant to peri-implantitis prevention. The chitosan-based nanoparticle coating enabled controlled and sustained miR-21 release over time, supporting prolonged modulation of inflammatory and osteogenic signaling pathways involved in peri-implant tissue homeostasis. Conclusions: The miR21-implant system, based on lecithin–PEI nanoparticles incorporated into a chitosan coating, represents a promising therapeutic strategy for peri-implantitis prevention. By enabling sustained local delivery of miR-21, this approach has the potential to preserve peri-implant bone architecture, modulate chronic inflammation, and enhance the osseointegration of titanium dental implants. Full article

Pure titanium (Ti) and its alloys are the gold standard for dental implants because a stable titanium dioxide passive film provides excellent corrosion resistance in physiological environments. In this study, we aimed to examine electrochemical interactions between Ti and cobalt–chromium–molybdenum alloy (CoCrMo), and between a novel Ti–magnesium composite (BIACOM TiMg) and CoCrMo, when immersed in everyday solutions representing beverage or oral hygiene exposure. Test solutions included Coca-Cola^®, lemon juice, Elmex^® fluoride gel, Listerine^® Cool Mint, and Sensodyne^® fluoride paste. Immersion experiments paired Ti sticks with CoCrMo sticks and, separately, BIACOM TiMg with CoCrMo sticks, with three measurements per configuration. When galvanically coupled with CoCrMo, immersion in Coca-Cola produced galvanic potential differences of ~983 mV for the BIACOM TiMg-CoCrMo couple and 830 mV for the commercially pure grade 4 (CP4) Ti-CoCrMo couple, indicating significant electrochemical instability. Both materials showed significant potential increases in Elmex fluoride gel. Listerine Cool Mint and Sensodyne fluoride exposure produced electrochemical interactions exceeding 200 mV. Significant differences in corrosion stability were observed between CP4 Ti and BIACOM TiMg. These findings indicate that material pairing and electrolyte environment significantly influence galvanic behavior, with the Ti-Mg composite showing greater susceptibility than CP4 Ti, informing dental/biomedical material selection in oral environments. Full article

This study evaluated the efficiency and potential risks associated with three clinical tools for removing cement-retained implant-supported prostheses: Magnetic Mallet, sliding hammer, and Coronaflex. The tests consisted of: cementation of three-unit bridge models onto titanium abutments with different geometries using Zinc Oxide non-eugenol or Zinc Phosphate cement. Seven different geometries of three-unit bridges were tested; therefore, a total of 7 bridges × 2 luting agents × 3 tools were combined in a full factorial analysis. Five test replicates were performed for each combination, resulting in a total of 5 × 7 × 2 × 3 = 210 retrieval tests. The 70 tests regarding the Coronaflex were taken from a previously conducted experiment on the topic, using the same dental bridge models and the same experimental conditions. Efficiency was assessed by the percentage of successful removals and the maximum force recorded with a piezoelectric load cell. For temporary cementations, the sliding hammer achieved the highest retrieval rate, while the Magnetic Mallet demonstrated comparable efficiency with lower forces. Coronaflex showed lower success rates and higher forces than Magnetic Mallet. For permanent cementations, most bridges were not removable, and attempts with the sliding hammer occasionally resulted in abutment screw damage. Within the limitations of this study, the Magnetic Mallet appears to be an effective option for removing bridges cemented with temporary cement, potentially in combination with a sliding hammer for highly retentive geometries. Zinc phosphate cement should be avoided when retrievability is desired, except for abutments with very low retention capability. Full article

Peri-implant infections pose a significant challenge in dental implantology. This study aimed to develop and characterize a chitosan–vancomycin coating for titanium surfaces, focusing on drug loading, release kinetics, antimicrobial performance, and cytocompatibility. Grade 4 titanium discs were coated with a chitosan film using the dip-coating technique and subsequently loaded with vancomycin through immersion in an aqueous solution. Coating morphology was examined by scanning electron microscopy (SEM). Vancomycin loading was quantified by spectrophotometry, and release kinetics were monitored over 144 h (6-day). Antimicrobial activity was assessed through agar diffusion assays against Staphylococcus aureus. Cytocompatibility was evaluated using human mesenchymal stem cells (hMSCs), whose metabolic activity, adhesion, and morphology were assessed over a 19-day culture period by resazurin assay and SEM. SEM analysis revealed a uniformly distributed, smooth, and crack-free chitosan film, which remained stable after drug loading. The coating exhibited a biphasic release profile, characterized by an initial burst followed by sustained release over six days, which maintained antimicrobial activity, as confirmed by inhibition zones. hMSCs adhered and proliferated on the coated surfaces, displaying normal morphology despite a transient reduction in metabolic activity on vancomycin-containing films. These findings support the potential of chitosan–vancomycin coatings as localized antimicrobial strategies for implant applications, warranting further in vivo and mechanical evaluations. 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

Background/Objectives: Formation of tight contacts between oral soft tissue and dental implants is a significant challenge in contemporary implantology. An essential role in this process is played by oral epithelial cells. In the present study, we investigated how titanium and zirconia surfaces with different roughness influence various parameters of oral epithelial cells in vitro. Methods: We used the human oral squamous carcinoma Ca9-22 cell line and cultured them on the following surfaces: machined smooth titanium (TiM) and zirconia (ZrM) surfaces, as well as sandblasted and acid-etched titanium moderately rough (SLA) and zirconia (ZLA) surfaces. Cell proliferation/viability was measured by CCK-8 assay, and cell morphology was analyzed by fluorescent microscopy. The gene expression of interleukin (IL)-8, intercellular adhesion molecule (ICAM)-1, E-cadherin, integrin (ITG)-α6, and ITG-β4 was measured by qPCR, and the content of IL-8 in conditioned media by ELISA. Results: At the initial culture phase, cell proliferation was promoted by rougher surfaces. Differences in cell attachment were observed between machined and moderately rough surfaces. Machined surfaces were associated with slightly higher IL-8 levels (p < 0.05). Furthermore, both ZLA and SLA surfaces promoted the expression of (ITG)-α, ITG-β4, and ICAM-1 in Ca9-22 cells (p < 0.05). Surface material had no impact on the investigated parameters. Conclusions: Under the limitations of this in vitro study, some properties of oral epithelial cells, particularly the immunological and barrier function, are moderately modified by roughness but not by material. Hence, the roughness of the implant surface might play a role in the quality of the peri-implant epithelium. 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

Background/Objectives: There is evidence of possible contamination of prosthetic components originating from dental laboratories. The aim of this study is to investigate the disinfectant effect of citric acid and polyethylene glycol on implant-prosthetic materials in comparison with an untreated control and chlorhexidine. Methods: A total of 720 disks made of three different materials (titanium grade V, zirconia coated with feldspathic ceramic, and PMMA) contaminated with three bacteria (Staphylococcus aureus, Enterococcus faecalis, and porphyromonas gingivalis) were analyzed. Four treatment groups were tested: citric acid, polyethylene glycol, chlorhexidine and an untreated control group. Two assessment periods (3 and 21 days of incubation) were used, with bacterial metabolic activity measured using the resazurin reduction test and then analyzed by electron microscopy. Results: The results show that chlorhexidine has a superior inhibitory effect on all materials and bacterial strains in the short-term evaluation (3 days), while citric acid and polyethylene glycol showed higher efficacy after 21 days. Citric acid also exhibits differential effects when applied to grade V titanium. These differences were statistically significant at p < 0.05. Conclusions: There is evidence to recommend chlorhexidine for the disinfection of laboratory prosthetic components, but the enhanced effect of citric acid on grade V titanium and its long-term efficacy make it clinically promising candidate. Full article

Background/Objectives: The purpose of this study was to assess the in vitro biocompatibility and corrosion resistance of five titanium alloys that have been recently developed for dental implant applications, whose compositions were designed to align with current approaches in the development of novel biomaterials. Priority was given to limiting the harmfulness associated with specific chemical elements present in common conventional alloys and increasing corrosion resistance to improve the biomaterial–tissue cellular interaction. Methods: For this purpose, five types of titanium alloys with original chemical compositions (Ti1–Ti5) were developed. The electrochemical behavior of the alloys was analyzed by evaluating the corrosion resistance in environments that simulate the oral environment, as well as the cellular behavior, by evaluating the viability, growth, and proliferation of human cells on osteoblasts and gingival fibroblasts. Detailed analysis of the chemical composition by scanning electron microscope (SEM/EDS) methods was used. The corrosion rate of the alloys in artificial saliva was tested using the polarization resistance technique (Tafel). Human osteoblasts (hFOB cell line) and human gingival fibroblasts (hFIB-G cell line) were used to measure biocompatibility in vitro. Results: The Ti5 alloy demonstrated the highest cell viability and the lowest corrosion rate (0.114 μm/year) among all tested compositions, with the Ti3 alloy containing Mo and Zr following closely behind. The Ti2 alloy exhibited reduced biocompatibility because of the inclusion of Ni and Fe in its composition. Conclusions: Taken together, the results of this study provide useful information on the basic characteristics of titanium alloys with original chemical compositions. The titanium alloys were analyzed in comparison with common conventional alloys (Cp–Ti and Ti6Al4V) as well as alloys such as Ti–Zr, Ti–Nb, and Ti–Nb–Zr–Ta, which are considered to be viable alternatives to conventional materials for making dental implants. Full article

Background/objectives: Zirconia dental implants are increasingly recognised as an alternative to titanium implants due to their biocompatibility and aesthetics. Initially developed as one-piece systems, zirconia implants have evolved into two-piece designs with different platform levels; however, comparative data on their primary and secondary stability– particularly as assessed by resonance frequency analysis (RFA)—and marginal bone dynamics remain limited. This case series aimed to evaluate the implant stability and marginal bone changes of two-piece zirconia implants with bone-level (BL) and tissue-level (TL) platforms in patients missing maxillary premolars. Methods: Thirteen zirconia implants (n = 13; 7 BL, 6 TL; Z5-TL/Z5-BL, Z-Systems, Switzerland) were placed in 11 patients with healed ridges. The implant stability quotient (ISQ) was measured immediately after insertion and before prosthetic loading. Lithium disilicate crowns were cemented after four months, and follow-ups were conducted for an average of 35 months (SD = 12). Results: Initial ISQ values ranged from 73 to 79, increasing to 76–84 at 3–4 months, indicating high implant stability for both BL and TL implants. The extent of marginal bone loss (MBL) after two years was greater around BL implants (mean 0.46 mm) compared to TL implants (mean 0.2 mm), although probing depths and bleeding on probing remained minimal in both groups, with only one TL implant showing gingival recession. Conclusions: Over a short observation period, two-piece zirconia implants with tissue-level platforms appeared to demonstrate superior marginal tissue stability. Further, larger-scale controlled studies are required to confirm these preliminary observations. Full article

Bone graft materials frequently employed in dental implant placement procedures, including hydroxyapatite and β-tricalcium phosphate (β-TCP), are typically granular in form, which complicates their manipulation and contributes to extended treatment durations. A tissue engineering approach utilizing readily manageable biomaterials in conjunction with mesenchymal stem cells (MSCs) represents the most promising approach in dentistry. This study assessed the bone-augmenting capacity at bone defect sites in inbred rats by seeding dedifferentiated fat (DFAT) cells onto a cotton-like bone graft scaffold composed of β-TCP and poly(L-lactic-co- glycolide) (PLGA), which was subsequently wrapped around titanium. As a control, cotton-like bone graft material without cells was used and wrapped around and transplanted. Four weeks post-implantation, computed tomography (CT) images of the DFAT group revealed a 1.25-fold enhancement in hard tissue formation compared to the control group. Histological analysis revealed compact structure in a dark red color surrounding the cotton-like bone graft material was observed on the titanium surface of DFAT group. Histomorphometric analysis revealed that the amount of hard tissue generated in the DFAT group was approximately 2.5 times higher than that observed in the control group. Moreover, this mineralized tissue demonstrated properties analogous to those observed in cortical bone. Collectively, these findings indicate that the composite of DFAT cells and cotton-like bone graft material holds potential for bone augmentation applications and represents a promising approach for regenerative therapies within the orofacial region. Full article

Titanium (Ti) and its alloys are widely used in orthopedic applications, including total hip and knee replacements, bone plates, and dental implants, because of their superior biocompatibility, bioactivity, corrosion resistance, and mechanical robustness. These alloys effectively overcome several limitations of conventional metallic implants, such as 316L stainless steel and Co-Cr alloys, particularly with respect to corrosion, fatigue performance, and biological response. However, dense Ti alloys possess a relatively high elastic modulus, which can cause stress shielding in load-bearing applications. This challenge has motivated significant research toward engineered porous Ti structures that exhibit a reduced and bone-matched modulus while preserving adequate mechanical integrity. This review provides a comprehensive examination of powder metallurgy and additive manufacturing approaches used to fabricate porous Ti and Ti-alloy scaffolds, including additive manufacturing and different powder metallurgy techniques. Processing routes are compared in terms of achievable porosity, pore size distribution, microstructural evolution, mechanical properties, and biological outcomes, with emphasis on the relationship between processing parameters, pore architecture, and functional performance. The reported findings indicate that optimized powder-metallurgy techniques can generate interconnected pores in the 100–500 μm range suitable for osseointegration while maintaining compressive strengths of 50–300 MPa, whereas additive manufacturing enables the precise control of hierarchical architectures but requires careful post-processing to remove adhered powder, stabilize microstructures, and ensure corrosion and wear resistance. In addition, this review integrates fundamental aspects of bone biology and bone implant interaction to contextualize the functional requirements of porous Ti scaffolds. Full article

Commercially pure (CP) titanium is widely used for long-term biomedical implants due to its high biocompatibility and corrosion resistance. However, its relatively low strength limits its use in highly loaded applications. Ultrafine-grained (UFG) titanium obtained through severe plastic deformation offers enhanced mechanical performance while maintaining the stability of CP titanium. This study investigates how electrochemical surface modification by anodization affects the corrosion, biological performance, and technological behavior of UFG titanium. TiO₂ layers with nanotubular and nanoporous morphologies were produced at anodization voltages between 20 and 60 V. Corrosion tests in physiological solution confirmed stable passive behavior with corrosion rates below 4 µm year⁻¹, and surface wettability increased markedly with anodization. Osteoblast-like MG-63 cells exhibited good viability on all anodized surfaces, with improved adhesion and proliferation on samples anodized at 60 V. The porous TiO₂ layers were successfully intercalated with dimethyl sulfoxide and ibuprofen, demonstrating potential for local drug delivery. Implantation simulations on real Nanoimplant^® prototypes confirmed sufficient mechanical stability of the anodized layer. Overall, the optimized anodization of UFG titanium enhances its biological response while maintaining corrosion resistance, supporting its clinical use in long-term dental and orthopedic implants with integrated drug-release functionality. Full article

Background: Whether nanoengineered titanium surfaces confer superior implant stability beyond modern microrough controls remains uncertain. Methods: This systematic review followed PRISMA 2020 guidance: comprehensive multi-database searching with de-duplication; dual independent screening, full-text assessment, and standardized data extraction for predefined outcomes (implant stability quotient [ISQ], mechanical anchorage by removal/push-out/pull-out torque, and histologic bone-to-implant contact). Risk of bias was appraised with RoB 2 for randomized trials, ROBINS-I for non-randomized clinical studies, and CAMARADES (animal experimentation). The certainty of clinical evidence was summarized using GRADE. Results: Across animal models, nanoengineered surfaces consistently improved early osseointegration indices (higher removal torque and bone-to-implant contact at initial healing). In clinical comparative studies, nanoengineered implants showed modest, time-limited gains in early stability (ISQ) versus microrough titanium. By 3–6 months, between-group differences typically diminished, and no consistent advantages were demonstrated for survival or marginal bone outcomes at later follow-up. Methodologic heterogeneity (surface chemistries, timepoints, outcome definitions) and small clinical samples limited quantitative synthesis. Overall, risk-of-bias concerns ranged from some concerns to high in non-randomized studies; the certainty of clinical evidence was low. Conclusions: Nanofeatured titanium surfaces improve early osseointegration but do not demonstrate a consistent long-term advantage over modern microrough implants. Current evidence supports an early osseointegration benefit without clear long-term clinical advantage over contemporary microrough implants. Adequately powered, head-to-head trials with standardized stability endpoints and ≥12-month follow-up are needed to determine whether early gains translate into patient-important outcomes. Full article