Nanoporous sol-gel-derived TiO(2) thin film on ITI Straumann dental implants improved soft tissue attachment in vivo.

The objective of this study was to evaluate growth and attachment of human gingival fibroblasts on nonresorbable sol-gel-derived nanoporous titania (TiO2) coated discs and noncoated commercially pure titania (cpTi) discs in vitro. The strength of attachment was evaluated using serial trypsinization. The number of cells detached from TiO2-substrates was 30% +/- 3%, whereas those detached from the cpTi was 58% +/- 4% indicating a stronger cell attachment on the coated surfaces. In scanning electron microscopy (SEM) images fewer cells, with more rounded shape, were seen with cpTi than with TiO2 after the detachment assay. Fibroblasts grew more efficiently on TiO2 than on cpTi substrates, showing significantly higher cell activities at all times. In transmission electron microscopy (TEM), a continuous layer of two to three cells thick covered the coated and noncoated discs after 7 days of culture. The plasma membrane of cells in contact with the coating was in close opposition and the cytoplasm was ultrastructurally similar to the cells grown on noncoated discs with well-preserved organelles. In conclusion, we demonstrated that the sol-gel-derived TiO2 coatings can facilitate cell growth and attachment of human gingival fibroblasts on titanium in vitro. This in vitro study is in line with our previous in vivo observations of improved soft tissue attachment of TiO2 coatings in comparison with cpTi.

Due to ageing of the population, the number of revision operations is expected to increase. Thus good fixation of medical implants is crucial for successful treatment. In our previous studies, a method to coat titanium implants with bioactive glass (BAG) via CO2 laser treatment was introduced. It allows to localise the application of a bioactive coating, without heat treatment of the whole implant. In the present study, cylindrical titanium implants were used (BAG-coated, control group: NaOH-treated and grit-blasted Ti). Three implants were placed in each femoral epicondyle of six rabbits. After eight weeks the animals were sacrificed. Half of the implants were subjected to a torsional loading test. In the control groups, the failure occurred at the bone-implant interface, in the BAG group the failure occurred mainly in the reacted glass. The implants coated with BAG were integrated into host bone without a connective tissue capsule and were surrounded by significantly more bone than the control implants. The findings indicate clearly that the use of CO2 laser radiation to create BAG coatings did not inhibit the bioactive properties of the glass in terms of osteoconduction.

The bioactivity of the surface reactive TiO(2) coatings for medical implants can be locally modified by CO(2) laser processing to match with the properties of surrounding tissues. The TiO(2) coatings heat-treated at 500 degrees C exhibit in vitro bioactivity. With further CO(2) laser treatment they exhibit enhanced in vitro bioactivity. The aim of this in vivo study was to compare the performance of heat-treated anatase-structured TiO(2) coatings with preheat-treated and CO(2) laser-treated rutile-structured coatings in terms of their ability to attach soft connective tissues. The coatings were characterized with TF-XRD and AFM. TiO(2)-coated discs were implanted in rats. The samples were analyzed with routine histology, SEM-EDS, and TEM. In both groups, already at 3 days, soft connective tissues were in immediate contact with the surface. No thick crystalline CaP layer was detected by SEM-EDS, but a thin amorphous CaP layer was detected by XPS. No gap between the cell membrane and the coating could be observed in TEM pictures. No differences were observed between the anatase- and rutile-structured coatings in terms of tissue responses. Further studies are needed to verify if the tissues are adherent to the surface of the implant.

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