Osseointegration of dental, craniofacial, and orthopedic implants is critical for their long-term success. Multifunctional surface treatment of implants was found to significantly improve cell adhesion and induce osteogenic differentiation of dental-derived stem cells in vitro. Moreover, local and sustained release of antibiotics via nanolayers from the surface of implants can present unparalleled therapeutic benefits in implant dentistry. Here, we present a layer-by-layer surface treatment of titanium implants capable of incorporating BMP-2–mimicking short peptides and gentamicin to improve their osseointegration and antibacterial features. Additionally, instead of conventional surface treatments, we employed polydopamine coating before layer-by-layer assembly to initiate the formation of the nanolayers on rough titanium surfaces. Cytocompatibility analysis demonstrated that modifying the titanium implant surface with layer-by-layer assembly did not have adverse effects on cellular viability. The implemented nanoscale coating provided sustained release of osteoinductive peptides with an antibacterial drug. The surface-functionalized implants showed successful osteogenic differentiation of periodontal ligament stem cells and antimicrobial activity in vitro and increased osseointegration in a rodent animal model 4 wk postsurgery as compared with untreated implants. Altogether, our in vitro and in vivo studies suggest that this approach can be extended to other dental and orthopedic implants since this surface functionalization showed improved osseointegration and an enhanced success rate.
Corrosion of implant components, including that of cover screws, has been reported as a possible etiological factor for implant failure. This study evaluated the presence of metallic particles in the soft tissues overlying two-stage implants after placing cover screws, by using a histological technique and energy-dispersive X-ray spectroscopy. The results showed large and small titanium particles in different layers of the soft tissue overlying the implant and cover screws in the majority of samples, with more particles near the cover screws. These particles might have contributed to the various degrees of inflammatory reactions detected in the different layers of the overlying soft tissues. Further studies on the corrosion of implants' metallic components are recommended, so that the implant failure rates could be minimized.
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