Search Results (129)

This research reports on the properties of oxide-ceramic coatings produced by plasma electrolytic oxidation in novel electrolyte solutions for implantology applications. A series of bioactive calcium-phosphate coatings was synthesized on medical-grade Ti-13Zr-13Nb alloy using the plasma electrolytic oxidation (PEO) method. Novel electrolytes enriched with calcium and phosphorus were developed, enabling the formation of coatings with tailored physicochemical and structural characteristics. A correlation was established between the electrolyte composition and the phase composition, thickness, morphology, porosity, and microhardness of the resulting coatings. The optimum coatings exhibited a Ca/P ratio close to that of natural human bone tissue, homogeneity, a well-developed porous surface topography, and controlled resorption behavior. For the first time, a mechanism of calcium-phosphate coating resorption in a biologically active environment has been proposed. It involves partial dissolution, the formation of apatite-like surface structures, and the subsequent controlled release of Ca and P ions. In vitro testing in simulated body fluid indicated the potential bioactivity of the synthesized coatings. The proposed calcium-phosphate coatings may be considered promising candidates for future implant surface modification. The results obtained are significant for the development of advanced orthopedic and dental implants, including those fabricated using additive manufacturing technologies. Full article

Background: Excessive heat during implant osteotomy adversely affects bone healing and osseointegration. It is essential to carefully study the effects of drill systems, motors, and irrigation methods on intraosseous temperature. We aim to analyze the predictors of intraosseous temperature variation during osteotomy in bovine bone blocks using the Helix GM (Titanium) and Zi Compact (Zirconium) drill systems in conjunction with three different surgical motors and irrigation conditions using a linear regression model. Materials and Methods: An in vitro experimental study was conducted at the Periodontology and Oral Implantology Laboratory of the Universidad Nacional Federico Villarreal. A total of 120 bovine rib bone blocks (1.5 cm) were prepared using a standardized osteotomy protocol involving lance drills and ∅ 2 mm and ∅ 3 mm helical drills from the Zi and Helix GM compact kits (Neodent, Curitiba, Brazil). Irrigation was performed with chlorhexidine 0.12% + CPC 0.05% at ambient temperature (21 °C). Osteotomies were executed with two surgical motors (Coxo and Driller) at 1200 rpm and 35 Ncm torque. The intraosseous temperature was recorded in real time via a calibrated Fluke TiS55+ (Fluke, Everett, WA, USA) infrared thermographic camera and validated using a probe thermometer. Statistical analyses used Stata 17, applying descriptive measures, t-tests, and linear regression at 95% confidence for reliability. Results: Osteotomies without irrigation consistently resulted in slightly higher intraosseous temperatures. The Helix GM system, with the ∅ 3 mm drill and Driller motor, produced a final temperature of 29.3 °C ± 2.0. The Zi system with the lance drill and drill motor produced a maximum temperature of 32.7 °C ± 2.3. Irrigation was successful, and the elevated temperatures after irrigation were close to the surgical room temperature of 21–23 °C. Linear regression analysis showed that the drill motor produced a statistically significant decrease in temperature (−2.29 °C; 95% CI: −4.36 to −0.21; p = 0.031) while the lance drill with no additional irrigation produced a statistically significant increase in temperature (0.24 °C; 95% CI: 0.06 to 0.42; p = 0.009). Conclusions: The absence of irrigation during osteotomy significantly increased the intraosseous temperature, potentially compromising bone integrity. The use of irrigation, especially with the Driller motor, demonstrates a protective thermal effect. Full article

Titanium base-free multi-unit abutment (MUA) restorations have been introduced to simplify implant prosthetic workflows by eliminating intermediate titanium bases and bonding interfaces. However, this approach modifies the biomechanical behavior of the prosthesis–abutment–implant complex and increases reliance on prosthetic screw performance. Despite growing clinical and commercial interest in these systems, the available evidence remains limited and fragmented, and the biomechanical consequences of removing the titanium base have not been clearly synthesized. Therefore, this critical review evaluated the influence of prosthetic screw design on the biomechanical behavior of titanium base-free MUA restorations, focusing on preload maintenance, load transfer, and mechanical stability. The evidence indicates that preload loss, screw loosening, and fatigue behavior are primary determinants of mechanical performance. Screw material, surface characteristics, and head geometry may affect preload generation, load distribution, and resistance to micromovement, although current evidence remains limited and heterogeneous. Short-term clinical outcomes appear acceptable when appropriate biomechanical and prosthetic protocols are followed; however, long-term comparative data are lacking. Titanium base-free MUA restorations should be considered a technique-sensitive approach requiring optimized screw selection, accurate prosthetic fit, and controlled occlusal loading. Further well-designed long-term studies are needed to establish their predictability. Full article

Background/Objectives: The development of high-performance biocompatible polymers such as zirconium-reinforced polyether ether ketone (BioHPP^®) has expanded the range of materials available for implant-supported prostheses, traditionally limited to metal alloys and zirconia. Due to its favorable mechanical properties and elastic modulus similar to cortical bone, BioHPP^® has been proposed as a potential alternative in implant prosthodontics. This systematic review aimed to analyze the biomechanical behavior of zirconium-reinforced PEEK and assess its advantages and limitations in implant prosthetic applications. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines, including studies published between 2011 and 2025 that evaluated the performance of BioHPP in implant prosthetic applications. Results: The search strategy identified 34 studies that met the inclusion criteria. The included studies evaluated mechanical properties such as fracture resistance, elastic modulus, stress distribution, and peri-implant tissue response. Zirconium-reinforced PEEK demonstrated fracture resistance values reaching up to 1623.31 N and an elastic modulus of approximately 4 GPa, comparable to cortical bone. Several studies also reported favorable stress distribution patterns and reduced mechanical complications when compared with conventional metallic materials. Conclusions: Zirconium-reinforced PEEK exhibits promising biomechanical characteristics for use in implant-supported prostheses, particularly due to its fracture resistance and bone-like elastic modulus. However, the available evidence is predominantly based on in vitro and finite element studies. Long-term clinical trials are required to confirm its clinical performance and establish definitive recommendations for routine use. Full article

Background/Objectives: Titanium implants remain the gold standard in implant dentistry. However, growing interest in metal-free alternatives has led to increased use of zirconia implants. Despite encouraging short-term outcomes, evidence regarding the medium- to long-term survival of one-piece zirconia implants (O-PZIs) and associated risk factors remains limited. The aim of this retrospective cohort study was to evaluate the survival of O-PZIs over follow-up periods of up to 8 years and to explore variables potentially associated with implant failure. Methods: This retrospective observational cohort study was conducted at a private dental clinic (Madrid, Spain). A total of 307 O-PZIs placed in 196 patients between 2017 and 2021 were analyzed. Implant survival was assessed using Kaplan–Meier analysis, while associations between clinical variables and implant failure were explored using chi-square tests and multivariate Cox regression models (p < 0.05). The mean follow-up period was 61.37 ± 2.25 months. Results: After a mean follow-up of 61.37 ± 2.25 months (range: 39–96 months), 42 failures were recorded, resulting in a cumulative survival rate of 86.32% (CI 95%: 79.28–92.96%). Most failures (64.29%) occurred before prosthetic loading. Kaplan–Meier analysis revealed significantly lower survival for tapered implants (p < 0.001) and among smokers (p < 0.001). Multivariate analysis indicated that only simultaneous guided bone regeneration (GBR) was independently associated with implant failure (Exp(B) = 3.191; 95% CI: 1.299–7.840; p = 0.011). However, this association should be interpreted with caution due to the retrospective design, potential confounding, limited number of events, and lack of adjustment for clustering at the patient level. The discrepancies observed between statistical methods highlight the importance of time-to-event analyses in implant research. Conclusions: Within the limitations of this study, O-PZIs demonstrated acceptable medium- to long-term survival. Simultaneous GBR may be associated with increased risk of failure. However, these findings should be considered exploratory. Further prospective studies are required to confirm these results and to better define risk factors in ceramic implant therapy. 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

In this study, niobium/zirconium dioxide/hydroxyapatite (Nb/ZrO₂/HA) composite coating was deposited on ZK60 magnesium alloy by the plasma spraying technique. The effects of spraying power and the powder feeding rate on the surface morphology, corrosion resistance, surface hardness, and surface roughness were investigated in this study. Tests were conducted through the optimal parameter combination obtained during the optimization process. The Nb/ZrO₂/HA coating consisted of α/β-TCP, TTCP, Nb₂O₅, HA, Nb, and t-ZrO₂ phases. The results suggest that the Ca/P ratio of the coating approached the ideal calcium-to-phosphorus ratio characteristic of bone implant material surfaces. Under the parameters of 33 kw and 18 g/min, the coating exhibited a dense, flattened morphology with significantly reduced roughness of Ra = 2.128 μm. Compared to the pure HA coating, the surface hardness and corrosion resistance of the Nb/ZrO₂/HA-coated sample increased by 28% and 56%, respectively. Furthermore, the mass loss rate in simulated body fluid (SBF) was considerably decreased by 33% compared to the HA coating. In vitro cytotoxicity assay reveals that the cell proliferation activity of the Nb/ZrO₂/HA composite coating was higher than that of the HA/ZrO₂ composite coating and the HA coating. Hence, the composite coating possessed favorable degradation controllability and biocompatibility. 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

Zirconium is a widely used material in the field of dentistry, employed for implants and their components as well as for the creation of crowns and veneers. Given that its biocompatibility has been studied and demonstrated in various fields of application, it is necessary to analyze how surface modification of this material influences its properties. The purpose of this study was to analyze the biocompatibility, initial adhesion (48 h), and morphology of periodontal ligament stem cells (PDLSCs) seeded on different zirconium surfaces treated with laser micropatterning, as well as plastic coverslips as a control. The Neubauer chamber was used to count the cells adhered to each of the sets, and confocal and scanning electron microscopy were employed to examine the adhesion and morphology of periodontal ligament stem cells on each of the zirconium surfaces studied. Results: Statistically significant differences were found in terms of primary cell adhesion, with sets 3 (grid topography) and 4 (channel topography) showing the most favorable characteristics for fibroblast adhesion. It was concluded that regular and moderately rough surfaces promoted better cell proliferation and development. Full article

Titanium-based alloys are widely used in dental implantology; however, the mechanical limitations of commercially pure titanium (cpTi) and unresolved concerns regarding stress shielding remain. This study evaluated the structure–property–function relationship of a novel β-type titanium-niobium-zirconium (Ti-Nb-Zr; TNZ) alloy for dental implant applications. Laboratory testing assessed the elemental composition, tensile properties, and fatigue resistance of the cpTi, compared with modified Grade 4 cpTi (MG4T). In parallel, a randomized, single-blind, controlled clinical trial was conducted over 12 months to compare the clinical performance of TNZ and MG4T implants under functional loading. A total of 80 participants (mean age: 54.2 years; 43 females, 37 males) were enrolled, with 77 completing the 12-month follow-up (TNZ: n = 38; MG4T: n = 39). Clinical outcomes included implant success and survival, peri-implant soft tissue parameters, marginal bone levels, fractal dimension (FD) analysis of trabecular bone, and adverse events. TNZ implants demonstrated superior fatigue resistance without an increase in the elastic modulus relative to MG4T. Clinically, both groups achieved 100% implant success and survival, with no implant-related adverse events. FD analysis revealed time-dependent bone remodeling without evidence of pathological adaptation. These findings support the functional viability of TNZ as a mechanically robust, biocompatible implant material. Further long-term, multicenter trials are warranted to confirm sustained clinical benefits and broader applicability. Full article

Background: Blue laser light has been the subject of research regarding the inactivation of microorganisms as a possible alternative to chemical treatment methods for a number of years. In dentistry, blue light could be used, for example, in the treatment of periodontitis/peri-implantitis, as well as in endodontics and against caries. It could serve as an alternative or supplement to traditional chemical and/or invasive methods. The antimicrobial effectiveness of a blue laser in relation to the speed of treatment is investigated using three different microbial test organisms in order to identify possible species differences. Methods: The test organisms Enterococcus faecalis, Streptococcus mutans, and Candida albicans were applied to smooth zirconium discs and treated twice with a diode laser at 445 nm wavelength with a traversing speed of 1, 2, and 4 mm/s. The antimicrobial effect was analysed based on the resulting colony-forming units on agar plates. The temperature was measured during the treatment. Preliminary tests were carried out using the MTT dye test to determine relevant setting parameters and the required energy dose. Results: Statistically significant differences were found between the negative control and the treated samples for all three tested organisms, with a maximum viability reduction of 1.8 log₁₀ CFU/mL for Enterococcus faecalis, 2.5 log₁₀ CFU/mL for Streptococcus mutans, and 1.0 log₁₀ CFU/mL for Candida albicans at 1 mm/s traversing speed, regarding estimated marginal means (p < 0.001). The temperature on the substrate surface reached 30 to 42 °C for all samples evaluated. Conclusions: Blue laser light (445 nm) demonstrates antimicrobial activity, which increases with prolonged exposure. Further research is needed to assess all key influencing parameters and define possible clinical applications. Full article

Objective: The Ti6Al4V titanium alloy is widely used for dental implants because of its excellent mechanical properties, corrosion resistance, and biocompatibility. However, its bioinert surface limits both osseointegration and resistance to bacterial colonization. Methods: To address these challenges, this study develops a composite coating based on calcium phosphate (CaP) and silver (Ag), reinforced with zirconium oxide (ZrO₂). The coating was deposited on Ti6Al4V using an immersion technique to improve the surface properties of the alloy. Electrochemical analyses (OCP, EIS, and potentiodynamic polarization) were performed in simulated physiological conditions to evaluate the corrosion behavior, while SEM/EDS was used to characterize the surface morphology and composition. Results: The Ag- and Zr-containing CaP coatings significantly improved the corrosion resistance of Ti6Al4V compared with uncoated and CaP-coated samples. Conclusions: This approach provides a promising strategy to enhance the electrochemical stability and long-term durability of titanium dental implants, thereby contributing to their reliable performance in the oral environment. Full article

Background/Objectives: A comparative study of silver (Ag), titanium nitride (TiN), zirconium nitride (ZrN), and copper (Cu) coatings on titanium (Ti) disks, considering the specifications of a microporous skin- and bone-integrated titanium pylon (SBIP), was performed to assess their biocompatibility, osseointegration, and mechanical properties. Methods: To assess cytotoxicity and biocompatibility, Ti disks with various metal coatings were co-cultured with FetMSCs and MG-63 cells for 1, 3, 7, and 14 days and subsequently evaluated using a cell viability assay, as supported by SEM and confocal microscopy studies. The antimicrobial activity of the selected four materials coating the implants was tested against S. aureus by mounting Ti disks onto the surface of LB agar dishes spread with a bacterial suspension and measuring the diameter of the growth inhibition zones. Quantitative Real-Time Polymerase Chain Reaction (RT-PCR) analysis of the relative gene expression of biomarkers that are associated with extracellular matrix components (fibronectin, vitronectin, type I collagen) and cell adhesion (α2, α5, αV integrins), as well as of osteogenic markers (osteopontin, osteonectin, TGF-β1, SMAD), was performed during the 14-day follow-up period. Additionally, the activity of matrix metalloproteinases (MMP-1, -2, -8, -9) was assessed. Results: All samples with metal coatings, except the copper coating, demonstrated a good cytotoxicity profile, as evidenced by the presence of a cellular monolayer on the sample surface on the 14th day of the follow-up period (as shown by SEM and inverted confocal microscopy). All metal coatings enhanced MMP activity, as well as cellular adhesion and osteogenic marker expression; however, TiN showed the highest values of these parameters. Significant inhibition of bacterial growth was observed only in the Ag-coated Ti disks, and it persisted for over 35 days. Conclusions: The silver-based coating, due to its high antibacterial activity, low cytotoxicity, and biointegrative capacity, can be recommended as the coating of choice for microporous titanium implants for further preclinical studies. Full article

Background: The implant–abutment interface has been thoroughly examined due to its impact on the success of implant healing and longevity. Removing the abutment is advantageous, but it changes the biomechanics of the implant fixture and restoration. This in vitro three-dimensional finite element analytical (FEA) study aims to evaluate the distribution of von Mises stress (VMS) in abutment-free and three additional implant abutment connections composed of various titanium alloys. Materials and methods: A three-dimensional implant-supported single-crown prosthesis model was digitally generated on the mandibular section using a combination of microcomputed tomography imaging (microCT), a computer-assisted designing (CAD) program (SolidWorks), Analysis of Systems (ANSYS), and a 3D digital scan (Visual Computing Lab). Four digital models [A (BioHorizons), B (Straumann AG), C abutment-free (Matrix), and D (TRI)] representing three different functional biomaterials [wrought Ti-6Al-4Va ELI, Roxolid (85% Ti, 15% Zr), and Ti-6Al-4V ELI] were subjected to simulated static/cyclic static loading in axial/oblique directions after being restored with highly translucent monolithic zirconia restoration. The stresses generated on the implant fixture, abutment, crown, screw, cortical, and cancellous bones were measured. Results: The highest VMSs were generated by the abutment-free (Model C, Matrix) implant system on the implant fixture [static (32.36 Mpa), cyclic static (83.34 Mpa)], screw [static (16.85 Mpa), cyclic static (30.33 Mpa), oblique (57.46 Mpa)], and cortical bone [static (26.55), cyclic static (108.99 Mpa), oblique (47.8 Mpa)]. The lowest VMSs in the implant fixture, abutment, screw, and crown were associated with the binary alloy Roxolid [83–87% Ti and 13–17% Zr]. Conclusions: Abutment-free implant systems generate twice the stress on cortical bone than other abutment implant systems while producing the highest stresses on the fixture and screw, therefore demanding further clinical investigations. Roxolid, a binary alloy of titanium and zirconia, showed the least overall stresses in different loadings and directions. Full article

Total hip arthroplasty (THA) is a widely performed and successful surgical treatment for degenerative joint disease. With increasing use in younger and more active patients, the demand for durable, biocompatible, and low-wear implant materials has grown. Oxidized zirconium (Oxinium, Zr2.5Nb) was introduced as a promising femoral head material, combining the strength of metal with the low-friction properties of ceramic. Despite encouraging early results, clinical reports have documented complications including head wear, especially after dislocation, and metallosis. We present the case of a 64-year-old male who underwent primary THA in 2009 and required revision in 2021 due to severe metallosis. Notably, no dislocation was observed that could explain the damage to the Oxinium head. Surface and subsurface analyses using X-ray photoelectron spectroscopy (XPS) and micro-indentation hardness testing revealed wear and deformation inconsistent with Oxinium’s anticipated durability. These findings highlight the importance of the femoral head–polyethylene liner interface in implant longevity. Although Oxinium–XLPE articulations remain promising, risks such as damage to the femoral head, liner dislocation, impingement, and metallosis must be carefully considered. Surgical technique, liner placement, and locking mechanisms play critical roles in preventing failure. Further biomechanical and clinical studies are needed to optimize implant design and improve long-term outcomes. Full article