Bone tissue response to experimental zirconia implants

Mihatovic, Ilja; Golubovic, Vladimir; Becker, Jürgen; Schwarz, Frank

doi:10.1007/s00784-016-1904-2

Cited by 23 publications

(20 citation statements)

References 37 publications

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“…When quantitative surface topography parameters were provided, increased surface roughness was associated with increased (Delgado‐Ruiz et al., ; Mihatovic, Golubovic, Becker & Schwarz, ) as well as with decreased BIC values (Mihatovic et al., ; Oh et al., ), whereas the differences were statistically not significant ( p > 0.05).…”

Section: Resultsmentioning

confidence: 99%

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Zirconia compared to titanium dental implants in preclinical studies—A systematic review and meta‐analysis

Roehling

Schlegel

Woelfler

et al. 2019

Clinical Oral Implants Res

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Objectives To evaluate whether zirconia implants demonstrate differences in hard and soft tissue integration compared to titanium implants in preclinical studies. Material and Methods In March 2017, electronic (MEDLINE, EMBASE) and hand search was performed to identify preclinical studies comparing zirconia and titanium implants. Primary outcomes were bone‐to‐implant contact (BIC) and removal torque out (RTQ), respectively, push‐in (PI) measurements. Secondary outcomes included biologic width (BW) dimensions. Results A total of 37 studies were included for data extraction after screening of 91 from 1,231 selected titles. Thirty‐seven experimental studies using six different species were identified. The follow‐up periods ranged between 0.4 and 56 weeks. For titanium, mean values of 59.1% (95% CI: 53.3 – 64.8), 102.6 Ncm (95% CI: 81.5 – 123.6), and 25.1 N (95% CI: 20.2 – 30.0) for BIC, RTQ, and PI were estimated, respectively. The mean values for zirconia were 55.9% (95% CI: 51.6 – 60.1), 71.5 Ncm (95% CI: 51.1 – 91.9), and 22.0 N (95% CI: 13.2 – 30.7) for corresponding parameters. Confounding factors such as animal species, implant material, loading protocol, and study or loading duration significantly influenced the outcomes. Similar qualitative soft tissue integration was reported for zirconia and titanium implants. However, faster maturation processes of epithelial and connective tissues around zirconia implants were assumed. Quantitatively, similar BW dimensions were evaluated for titanium (3.5 mm; 95% CI: 2.9 – 4.2) and zirconia (3.2 mm; 95% CI: 2.7 – 3.7), whereas the loading protocol significantly influenced the outcomes. Conclusions Zirconia and titanium implants demonstrate a similar soft and hard tissue integration capacity. However, titanium tended to show a faster initial osseointegration process compared to zirconia. Importantly, not only material characteristics but predominantly animal species and study protocols can significantly influence the outcomes.

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Section: Resultsmentioning

confidence: 99%

“…Ten studies were included, and the follow-up periods ranged be- (Mihatovic et al, 2017;Oh et al, 2015), whereas the differences were statistically not significant (p > 0.05).…”

Section: Caninesmentioning

confidence: 96%

Zirconia compared to titanium dental implants in preclinical studies—A systematic review and meta‐analysis

Roehling

Schlegel

Woelfler

et al. 2019

Clinical Oral Implants Res

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“…54,[58][59][60][61][62] As a result, the strength of bone-implant integration and the percentage of bone formation around implants are lower for zirconia than titanium implants. [39][40][41]55,[59][60][61]63,64 Clinical studies also indicated that the success rate for zirconia implants is significantly lower than that for commonly used titanium implants. 39,59 Here we have created a Y-TZP zirconia surface with distinct hierarchical surface morphology consisting of meso-, micro-, and nano-scale roughness.…”

Section: Introductionmentioning

confidence: 99%

Biological and osseointegration capabilities of hierarchically (meso-/micro-/nano-scale) roughened zirconia

Rezaei¹,

Hasegawa²,

Ishijima³

et al. 2018

IJN

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PurposeZirconia is a potential alternative to titanium for dental and orthopedic implants. Here we report the biological and bone integration capabilities of a new zirconia surface with distinct morphology at the meso-, micro-, and nano-scales.MethodsMachine-smooth and roughened zirconia disks were prepared from yttria-stabilized tetragonal zirconia polycrystal (Y-TZP), with rough zirconia created by solid-state laser sculpting. Morphology of the surfaces was analyzed by three-dimensional imaging and profiling. Rat femur-derived bone marrow cells were cultured on zirconia disks. Zirconia implants were placed in rat femurs and the strength of osseointegration was evaluated by biomechanical push-in test.ResultsThe rough zirconia surface was characterized by meso-scale (50 µm wide, 6–8 µm deep) grooves, micro-scale (1–10 µm wide, 0.1–3 µm deep) valleys, and nano-scale (10–400 nm wide, 10–300 nm high) nodules, whereas the machined surface was flat and uniform. The average roughness (Ra) of rough zirconia was five times greater than that of machined zirconia. The expression of bone-related genes such as collagen I, osteopontin, osteocalcin, and BMP-2 was 7–25 times upregulated in osteoblasts on rough zirconia at the early stage of culture. The number of attached cells and rate of proliferation were similar between machined and rough zirconia. The strength of osseointegration for rough zirconia was twice that of machined zirconia at weeks two and four of healing, with evidence of mineralized tissue persisting around rough zirconia implants as visualized by electron microscopy and elemental analysis.ConclusionThis unique meso-/micro-/nano-scale rough zirconia showed a remarkable increase in osseointegration compared to machine-smooth zirconia associated with accelerated differentiation of osteoblasts. Cell attachment and proliferation were not compromised on rough zirconia unlike on rough titanium. This is the first report introducing a rough zirconia surface with distinct hierarchical morphology and providing an effective strategy to improve and develop zirconia implants.

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“…Despite lacking the ductility of titanium, zirconia in previous studies demonstrated a mechanical strength similar to Ti and sufficient to withstand mastication forces under simulated oral environment conditions [ 8 , 9 , 10 ]. Furthermore, recent results from clinical and in vitro studies involving zirconia demonstrated osseointegration comparable to titanium, which was also partially dependent on surface roughness and hydrophilicity of both substrates [ 11 , 12 , 13 ]. In an in vivo study, similar bone-implant contact was found on both titanium and zirconia implants after 12 weeks [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Dicationic Imidazolium-Based Ionic Liquid Coatings on Zirconia Surfaces: Physico-Chemical and Biological Characterization

Sandhu

Gindri

Siddiqui

et al. 2017

JFB

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In the present work, dicationic imidazolium-based ionic liquids (ILs) were investigated as multi-functional coatings on a zirconia (ZrO2) surface to prevent biofilm formation and enhance the wear performance of zirconia while maintaining the material’s compatibility with host cells. ILs containing phenylalanine and methionine were synthesized and deposited on zirconia. Intermolecular interactions driving IL deposition on zirconia were studied using X-ray photoelectron spectroscopy (XPS). Anti-biofilm activity and cell compatibility were evaluated in vitro after one and seven days, and wear performance was tested using a pin-on-disk apparatus. ILs were observed to form strong hydrogen bonds with zirconia. IL containing phenylalanine formed a stable film on the surface after one and seven days in phosphate-buffered saline (PBS) and artificial saliva and showed excellent anti-biofilm properties against Streptococcus salivarius and Streptococcus sanguinis. Compatibility with gingival fibroblasts and pre-osteoblasts was maintained, and conditions for growth and differentiation were preserved. A significantly lower coefficient of friction and wear volume loss were observed for IL-coated surfaces as compared to non-coated substrates. Overall, zirconia is an emerging alternative to titanium in dental implants systems, and this study provides additional evidence of the materials’ behavior and IL coatings as a potential surface treatment technology for improvement of its properties.

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Bone tissue response to experimental zirconia implants

Abstract: Zirconia has been introduced as an alternative biomaterial for dental implants. A profound knowledge about the bone tissue response at zirconia implant surfaces is necessary as it plays an important role for proper osseointegration and long-term stability.

Cited by 23 publications

References 37 publications

Zirconia compared to titanium dental implants in preclinical studies—A systematic review and meta‐analysis

Zirconia compared to titanium dental implants in preclinical studies—A systematic review and meta‐analysis

Biological and osseointegration capabilities of hierarchically (meso-/micro-/nano-scale) roughened zirconia

Dicationic Imidazolium-Based Ionic Liquid Coatings on Zirconia Surfaces: Physico-Chemical and Biological Characterization

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