The success of titanium dental implants depends on their osseointegration into the bone, which is determined by the composition and surface properties of the implant in close contact with the bone. There is a wide variety of implants on the market. Is it possible to identify the implant with the best composition and surface topography for optimal osseointegration? To this aim, 13 brands of dental implants from nine distinct manufacturers have been selected and their composition and surface topography determined. The obtained results show differences between these implants, in this case, the Ssk averages of the three measurements performed on each implant were positive, or 0.4 (0.1–0.8), indicating that the roughness of all implants analyzed was primarily textured and not flat. Like Sa, we found the highest Sdr for implants subjected only to sandblasting. In addition, only the ALS-active® implant had a modified microstructure on its surface. However, analysis of the NANOTITE implant surface revealed a 1.40% presence of calcium which we consider too low to have an effect on bone formation around the implant. As a result, we have also highlighted the lack of a recognized independent standard for dental implant surface conditions and the lack of independent quality control vis-à-vis manufacturers. Of all the surface types studied, none proved more satisfactory than another.
The osseointegration of implants is defined as the direct anatomical and functional connection between neoformed living bone and the surface of a supporting implant. The biological compatibility of implants depends on various parameters, such as the nature of the material, chemical composition, surface topography, chemistry and loading, surface treatment, and physical and mechanical properties. In this context, the objective of this study is to evaluate the biocompatibility of rough (Ra = 1 µm) and smooth (Ra = 0 µm) surface conditions of yttria–zirconia (Y-TZP) discs compared to pure zirconia (ZrO2) discs by combining a classical toxicological test, morphological observations by SEM, and a transcriptomic analysis on an in vitro model of human Saos-2 bone cells. Similar cell proliferation rates were observed between ZrO2 and Y-TZP discs and control cells, regardless of the surface topography, at up to 96 h of exposure. Dense cell matting was similarly observed on the surfaces of both materials. Interestingly, only 110 transcripts were differentially expressed across the human transcriptome, consistent with the excellent biocompatibility of Y-TZP reported in the literature. These deregulated transcripts are mainly involved in two pathways, the first being related to “mineral uptake” and the second being the “immune response”. These observations suggest that Y-TZP is an interesting candidate for application in implantology.
The study presented here aimed to assess the ability of Desulfovibrio fairfieldensis bacteria to adhere to and form biofilm on the structure of titanium used in implants. D. fairfieldensis was found in the periodontal pockets in the oral environment, indicating that these bacteria can colonize the implant-bone interface and consequently cause bone infection and implant corrosion. Plates of implantable titanium, of which surfaces were characterized by scanning electronic microscopy and Raman spectroscopy, were immersed in several suspensions of D. fairfieldensis cells containing potassium nitrate on the one hand, and artificial saliva or a sulfato-reducing bacterial culture medium on the other hand. Following various incubation timepoints bacteria were counted in different media to determine their doubling time and titanium samples are checked for and determination of the total number of adhered bacteria and biofilm formation. Adhesion of D. fairfieldensis on titanium occurs at rates ranging from 2.105 to 4.6.106 bacteria h-1cm-2 in the first 18 h of incubation on both native and implantable titanium samples. Following that time, the increase in cell numbers per h and cm2 is attributed to growth in adhered bacteria. After 30 days of incubation in a nutrient-rich medium, dense biofilms are observed forming on the implant surface where bacteria became embedded in a layer of polymers D. fairfieldensis is able of adhering to an implantable titanium surface in order to form a biofilm. Further studies are still necessary, however, to assess whether this adhesion still occurs in an environment containing saliva or serum proteins that may alter the implant surface.
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