Search Results (798)

Background: Primary stability and long-term osseointegration depend on bone healing surrounding dental implants. Implant macrogeometry is crucial for controlling insertion torque and the biological reaction of peri-implant bone. This study assessed the impact of an implant design meant to lessen cortical bone compression on early bone healing. Methods: Forty titanium prototype implants (3 × 6 mm) were equally divided into Control (standard macrogeometry) and Test (macrogeometry with healing chambers) groups. Initial insertion torque was measured in vitro using synthetic bone blocks. Subsequently, an in vivo rabbit tibia model was used (n = 10 implants per group) to assess early healing. At 21 days, histological sections were analyzed for bone-to-implant contact (BIC%) at three cervical positions (C1, C2, and C3). Additionally, digital radiographs of the cervical region were evaluated using RGB color mapping, where distinct color channels quantified varying degrees of bone density. Results: The in vitro insertion torque for the Control group was significantly greater than the Test group (8.01 vs. 5.70 Ncm). The in vivo histomorphometric analysis indicated improved integration for the Test design, showing substantially higher BIC% at the C2 (59.30% vs. 40.30%) and C3 (42.10% vs. 17.90%) positions. Furthermore, radiographic RGB analysis revealed that the Test group possessed a higher blue channel contribution, indicating greater mineralized tissue density. Conclusions: These results imply that modifying implant macrogeometry to lower insertion torque and minimize cortical bone compression favorably enhances early cervical bone healing and osseointegration. Full article

Aim: This study aimed to compare two-piece zirconia and two-piece titanium implants inserted into the anterior mandible for removable overdentures in a 3-year randomized split-mouth clinical trial. Methods: Twenty fully edentulous mandibular patients received two zirconia and two titanium implants allocated by computer-generated randomization. The primary endpoint was bleeding-on-probing (BOP) at 12 months. Secondary outcomes included implant survival and success (Albrektsson criteria), marginal bone level changes, peri-implant cytokines (IL-1β, IL-6, and TNFα), prosthetic complications, and patient-reported outcomes (PROMs). Results: After 3 years, overall survival was 98.61% and overall success was 84.72%. Titanium implants showed higher success compared with zirconia implants (91.70% vs. 77.78%), while survival was 100% and 97.22%, respectively. Marginal bone loss was significantly greater around zirconia implants at 36 months (p < 0.01). No significant differences were observed in IL-1β, IL-6, or TNFα levels up to 12 months. PROMs revealed a trade-off, with zirconia favored for esthetics and cleaning perception, while titanium was rated superior for stability. Conclusions: Within the limitations of this split-mouth RCT, zirconia implants demonstrated reduced success and inferior marginal bone stability compared with titanium implants in overdenture therapy. Careful case selection and close follow-up appear essential when zirconia implants are used in this indication. Full article

Dental implants are widely used to replace missing teeth, but peri-implantitis remains a major biological complication associated with bacterial biofilm formation on implant surfaces. The increasing incidence of peri-implant infections underscores the need for alternative antimicrobial strategies that effectively decontaminate complex titanium implant surfaces. This study evaluated the inhibitory effect of low-temperature microwave argon plasma on bacteria in an experimental model simulating peri-implant conditions and compared the responses of microorganisms with different biological characteristics. A 3D-printed mandibular bone segment model with an inserted Straumann BLX Roxolid^® dental implant was used to reproduce the peri-implant environment. Bacterial suspensions of Streptococcus mutans NBIMCC 1786 and the extremophilic bacterium Chromohalobacter canadensis NBIMCC 9077 have been exposed to a microwave non-equilibrium argon plasma jet (2.45 GHz, atmospheric pressure) for 1–7 min. Optical density measurements and colony growth analysis were used to assess antimicrobial effects. Plasma treatment induced a pronounced reduction in bacterial growth during the early post-treatment period. In C. canadensis, growth inhibition reached a plateau (~47–55% at 24 h) regardless of exposure time. In contrast, S. mutans showed a nonlinear response, with stable inhibition after short exposures (1–3 min) and partial recovery after longer treatments (5–7 min). These findings indicate that microwave argon plasma exhibits significant antimicrobial activity under controlled in vitro conditions, although its effectiveness depends on microorganism-specific biological characteristics. Because the present model was based on simplified single-species systems, direct clinical extrapolation remains limited and should be addressed in future studies using polymicrobial peri-implant biofilm models. Full article

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

Titanium dental implants are widely regarded as the gold standard for the rehabilitation of missing teeth due to their high survival rates and favorable mechanical properties. However, in the oral environment, implant materials are continuously exposed to complex chemical, mechanical, and biological factors that may lead to surface degradation, including corrosion, tribocorrosion, and mechanical wear. These processes can alter implant surface characteristics and influence biological responses in peri-implant tissues. Zirconia implants have been introduced as alternative material due to their favorable aesthetics and biocompatibility. Nevertheless, zirconia ceramics are also susceptible to degradation phenomena, including hydrothermal aging, phase transformation, and surface wear under specific conditions, although their clinical relevance remains unclear. In addition, emerging hybrid titanium–zirconia implant systems introduce new considerations regarding surface stability. This scoping review, conducted in accordance with PRISMA-ScR guidelines, summarizes the current evidence on degradation mechanisms affecting titanium, zirconia, and hybrid dental implants, with particular focus on processes occurring in the oral environment and their biological and clinical implications. The available evidence differs substantially between the two materials. While titanium degradation is well documented and supported by both experimental and clinical studies, the evidence for a hybrid implant remains limited and is largely based on in vitro and mechanistic data. 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

Titanium–silver (Ti–Ag) and titanium–copper (Ti–Cu) alloys have been developed to improve the mechanical properties and machinability of titanium (Ti) for dental applications while maintaining corrosion resistance comparable to that of pure Ti. Herein, cylindrical dental implants composed of experimental Ti–20Ag, Ti–30Ag, Ti–5Cu, and Ti–10Cu (mass%) alloys were fabricated and implanted into the jawbones of beagle dogs to evaluate bone compatibility. Pure Ti and Ti–6Al–4V alloy implants were used as controls. Because the implant surfaces were mechanically polished, the experimental alloys, which exhibited higher hardness than Ti, showed lower surface roughness than Ti. Radiographic observations revealed no remarkable bone resorption around any implants during the experimental period. Histological evaluation demonstrated new bone formation and partial bone contact around implants at 1 and 3 months post-implantation. Although the bone–implant contact ratio was relatively low owing to the cylindrical implant design and limited initial stability, no significant differences were observed between the experimental alloys and Ti. These results indicate that Ti–Ag and Ti–Cu alloys improve mechanical properties while maintaining bone compatibility comparable to that of Ti, suggesting their potential as candidate materials for dental implant applications, particularly for narrow dental implants. 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

Background: Immediate loading of dental implants shortens treatment time and improves early function, but it also exposes the healing peri-implant tissue to a critical mechanical environment. This study compared the biomechanical and mechanobiological response of a conventional threaded implant and a porous scaffold-based implant under immediate and delayed loading conditions. Methods: A three-dimensional finite element model of a bone block with a 0.2 mm peri-implant callus was developed in ABAQUS/Standard. Model A was a threaded Ti-6Al-4V implant, while Model B was a porous implant with 64.26% porosity. Bone tissues were modeled as poroelastic materials. Immediate and delayed loading were simulated through frictional and tied bone-implant interfaces, respectively. Mechanobiological predictions were performed using the Prendergast-Huiskes stimulus. Results: Under immediate loading, the porous implant reduced cortical bone stress (32.5 MPa vs. 88 MPa) and markedly increased callus stimulation (20.5–31.6 MPa vs. about 2.5 MPa) compared with the threaded implant. Mechanobiological analysis showed that Model B promoted higher fractions of immature and mature bone and lower fractions of cartilage and fibrous tissue. In all cases, implant stresses remained below the yield strength of the corresponding materials. Conclusions: The porous implant provided a more favorable mechanical environment for early peri-implant healing, particularly under immediate loading, and may be a promising strategy to enhance callus maturation and reduce stress shielding. Full article

Titanium alloys are widely used in dental implants due to their excellent mechanical properties. However, their inertness and poor antibacterial activity cause interfacial loosening and failure, shortening service life. This study integrates surface microtexturing with coating technologies, employing modified light-curing composite resins to boost the bioactivity of medical titanium alloys via surface modification. The results reveal that surface microtexturing enlarges the coating-substrate contact area by 42.5% compared with rough surfaces, concurrently diminishing stress per unit area, and the coating on microtextured Ti-6Al-4V (TC4) surfaces achieves adhesion with a damaged area of only 0.5%, thereby notably enhancing adhesion between the coating and TC4 matrix. In comparison, with rough surfaces (surface roughness of 0.658 μm), smooth TC4 planes (surface roughness of 0.014 μm) show a significantly reduced bacterial colony count (from 130 ± 6 to 42 ± 3) with an antibacterial rate of 67.7%, as the water contact angle on TC4 surfaces increases with decreasing roughness (reaching 80.95° on the smoothest surface), making bacterial adhesion more challenging and reducing colonization. The composite resin coating based on a mixture of titanium-doped hydroxyapatite and titanium dioxide (Ti-HA/TiO₂) further improves the antibacterial rate to 74.6% through a photocatalytic synergistic effect and endows TC4 with excellent remineralization capacity—mineralization deposits appear on the coated surface after 3 days of immersion in artificial saliva, while no obvious deposits are found on uncoated rough and smooth surfaces even after 7 days—thereby enhancing its bioactivity effectively. This study on the modification of Ti-based implant surfaces will enrich the field by introducing new technologies and methodologies. These advancements provide a theoretical basis for improvement of the remineralization capacity and antibacterial properties of Ti-based dental implants, thereby promoting broader biomedical applications. Full article

With increasing life expectancy and an aging global population, the demand for orthopedic and dental implants is increasing. Recently developed, citric-acid-based anodization processes facilitate the production of more bioactive oxide layers by incorporating important bone minerals such as Ca, P, and Mg and forming bone-like crystalline compounds such as carbonated apatite on titanium implant materials. The primary goal of the present study was to evaluate the applicability of these anodization processes to solid and 3D-printed titanium alloy substrates. The anodized oxides produced on each solid or 3D-printed lattice substrate revealed multi-scaled surface roughness profiles as evidenced by scanning electron microscopy, optical microscopy, and surface roughness analyses. Additionally, each oxide group was shown to incorporate substantial amounts of Ca, P, and Mg bone-mineral dopants and form AB-type carbonated apatite, as shown using a combination of energy-dispersive spectroscopy, X-ray photoelectron spectroscopy, X-ray diffraction, and attenuated total reflectance–Fourier transform infrared spectroscopy analyses. Finally, each oxide group showed sustained Ca, P, and Mg ion release during an inductively coupled plasma spectroscopy dissolution assessment, and demonstrated early apatite-forming ability during simulated body fluid bioactivity testing. The findings of this study show much promise for the applicability of these novel oxide coatings to a wide variety of future titanium implant 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

Selective laser melting (SLM) is an additive manufacturing method based on powder bed fusion that has gained prominence in prosthodontics for its capability to create intricate, patient-specific metal restorations with precision and consistency. SLM has become an important part of digital dental workflows, allowing for the direct creation of dental frameworks from computer-aided design (CAD), offering advantages over traditional casting and subtractive milling techniques. This review outlines the fundamentals of SLM, the dental alloys commonly employed, and the microstructural characteristics that affect mechanical properties, corrosion resistance, and biocompatibility. It explores current uses in removable partial denture frameworks, fixed dental prostheses, metal–ceramic restorations, implant-supported prosthetics, and maxillofacial rehabilitation. Alloys based on cobalt–chromium and titanium produced through SLM exhibit strong mechanical properties, fatigue resistance, and biological compatibility when suitable post-processing is conducted. Despite these advantages, issues such as surface roughness, porosity, anisotropy, powder handling, and high costs remain, and there is a lack of extensive long-term clinical data. Ongoing process refinement and clinical validation are crucial for the wider integration of SLM into standard prosthodontic practice. 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

Dental implants have become common for restoring function and aesthetics after edentulism, with titanium (Ti) remaining the most widely used material due to its excellent mechanical properties and biocompatibility. Despite their clinical success, long-term performance is strongly influenced by surface characteristics, which regulate osseointegration and susceptibility to bacterial colonisation. Consequently, surface modification approaches have become critical strategies to enhance implant stability, bioactivity and longevity. This review critically evaluates conventional, advanced, and hybrid surface modification strategies. Subtractive methods, such as sandblasting and acid etching, increase microroughness (Ra 1.5–3 μm), enhancing osteoblast attachment and differentiation, but may promote bacterial adhesion and surface contamination. Combined treatments like SLA and SLActive generate hierarchical micro–nano topographies, improving protein adsorption, early-stage osteoblast proliferation (up to 2-fold), and clinical stability. Laser ablation and photofunctionalisation further modulate surface chemistry and wettability, accelerating osseointegration and epithelial cell adhesion. Coating approaches, including layer-by-layer self-assembly, nanospray drying, plasma spraying, and piezoelectric nanocomposites, introduce antimicrobial activity (>95% reduction in Escherichia coli or Staphylococcus aureus) and enhanced osteogenic differentiation with mechanical stability, with adhesion values reaching 49 MPa. Hybrid techniques such as sol–gel, hydrothermal, and anodisation provide controlled topography, chemical composition, and bioactivity, promoting early bone-to-implant contact (BIC increase of 10%–25%) in preclinical models. Notwithstanding promising in vitro and in vivo outcomes, variability in processing parameters and limited standardisation restrict large-scale clinical translation. Overall, contemporary Ti surface engineering emphasises a synergistic balance of topography, chemistry, wettability, and hierarchical structuring to optimise biological performance for dental implant applications. Full article