The integration of peri-implant soft tissues around zirconia abutments: Challenges and strategies

Tang, Kai; Luo, Meng-Lin; Zhou, Wei; Niu, Li Na; Chen, Ji Hua; Wang, Fu

doi:10.1016/j.bioactmat.2023.04.009

Cited by 7 publications

(4 citation statements)

References 175 publications

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“…Nevertheless, a recent review advocates for metal free and aesthetic zirconia abutments with different surface modification for soft tissue attachment over Ti and its alloys. 130 On the other hand, biological coatings are potent with cell/tissue adhesive properties, but they are costineffective as they are prone to proteolytic degradation by the action of matrix metalloproteases (MMPs). Clearly, there is no ideal coating that can glue the skin to transcutaneous metallic prostheses.…”

Section: Surface Coatings For Soft Tissue Attachmentmentioning

confidence: 99%

“…Alumina and zirconia are inert bioceramics that trigger minimal peri-implant inflammation, but they do not actively promote soft tissue interactions at the skin–implant interface. Nevertheless, a recent review advocates for metal free and aesthetic zirconia abutments with different surface modification for soft tissue attachment over Ti and its alloys . On the other hand, biological coatings are potent with cell/tissue adhesive properties, but they are cost-ineffective as they are prone to proteolytic degradation by the action of matrix metalloproteases (MMPs).…”

Section: Hard and Soft Tissue Integration Around Percutaneous Bone-an...mentioning

confidence: 99%

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Soft and Hard Tissue Integration around Percutaneous Bone-Anchored Titanium Prostheses: Toward Achieving Holistic Biointegration

Shrivas,

Samaur,

Yadav

et al. 2024

ACS Biomater. Sci. Eng.

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A holistic biointegration of percutaneous boneanchored metallic prostheses with both hard and soft tissues dictates their longevity in the human body. While titanium (Ti) has nearly solved osseointegration, soft tissue integration of percutaneous metallic prostheses is a perennial problem. Unlike the firm soft tissue sealing in biological percutaneous structures (fingernails and teeth), foreign body response of the skin to titanium (Ti) leads to inflammation, epidermal downgrowth and inferior peri-implant soft tissue sealing. This review discusses various implant surface treatments/texturing and coatings for osseointegration, soft tissue integration, and against bacterial attachment. While surface microroughness by SLA (sandblasting with large grit and acid etched) and porous calcium phosphate (CaP) coatings improve Ti osseointegration, smooth and textured titania nanopores, nanotubes, microgrooves, and biomolecular coatings encourage soft tissue attachment. However, the inferior peri-implant soft tissue sealing compared to natural teeth can lead to peri-implantitis. Toward this end, the application of smart multifunctional bioadhesives with strong adhesion to soft tissues, mechanical resilience, durability, antibacterial, and immunomodulatory properties for soft tissue attachment to metallic prostheses is proposed.

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Section: Surface Coatings For Soft Tissue Attachmentmentioning

confidence: 99%

Section: Hard and Soft Tissue Integration Around Percutaneous Bone-an...mentioning

confidence: 99%

Soft and Hard Tissue Integration around Percutaneous Bone-Anchored Titanium Prostheses: Toward Achieving Holistic Biointegration

Shrivas,

Samaur,

Yadav

et al. 2024

ACS Biomater. Sci. Eng.

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“…In recent years, the use of zirconia abutments in clinical practice had significantly increased. Zirconia has mechanical properties comparable to titanium, fully supporting the masticatory function of restorations in the mouth [ 10 ]; Compared to traditional titanium abutments, zirconia abutments have superior aesthetic performance, significantly reducing the risk of gingival translucency in anterior dental implants [ 11 ]; Zirconia abutments are also known for their bacterial resistance, with a biologically inert surface that is less prone to bacterial attachment compared to titanium, reducing the risk of infection in the surrounding tissues [ 12 ]. However, the biologically inert surface of zirconia also affects its integration with the surrounding soft tissues.…”

Section: Introductionmentioning

confidence: 99%

Silk fibroin microgrooved zirconia surfaces improve connective tissue sealing through mediating glycolysis of fibroblasts

Yan,

Cai

et al. 2024

Materials Today Bio

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“…33,80 The trans-gingival site of the implant communicates with the oral cavity and is directly subjected to the invasion of bacteria. 81 Good connective tissue sealing can effectively maintain the stability of the 82,83 Once tissue inflammation and hyperplasia occur at the trans-gingival site, gingival edema occurs, the epithelium grows excessively into the gingival sulcus, and the peri-implant gingival sealing is destroyed. 81 Therefore, it is most important to inspect the inflammatory response and capsulation of connective tissue around nanostructured TLM abutments with Ag PIII treatment.…”

mentioning

confidence: 99%

Biocompatible Nanostructured Silver-Incorporated Implant Surfaces Show Effective Antibacterial, Osteogenic, and Anti-Inflammatory Effects in vitro and in Rat Model

Gao,

Jiang,

Niu

et al. 2023

IJN

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Introduction Titanium (Ti) and its alloys are widely utilized in endosseous implants. However, their clinical efficacy is marred by complications arising from bacterial infections owing to their inadequate antibacterial properties. Consequently, enhancing the antibacterial attributes of implant surfaces stands as a pivotal objective in the realm of implantable materials research. Methods In this study, we employed sequential anodization and plasma immersion ion implantation (PIII) technology to fabricate a silver-embedded sparsely titania nanotube array (SNT) on the near-β titanium alloy Ti-5Zr-3Sn-5Mo-15Nb (TLM) implants. The surface characteristics, antimicrobial properties, biocompatibility, and osteogenic activity of the silver-nanomodified SNT implant (SNT Ag) surface, alongside peri-implant inflammatory responses, were meticulously assessed through a combination of in vitro and in vivo analyses. Results Compared with polished TLM and SNT, the silver-embedded SNT (SNT Ag) surface retained the basic shape of nanotubes and stably released Ag + at the ppm level for a long time, which demonstrated an effective inhibition and bactericidal activity against Staphylococcus aureus (SA) while maintaining ideal cytocompatibility. Additionally, the subtle modifications in nanotubular topography induced by silver implantation endowed SNT Ag with enhanced osteogenic activity and mitigated inflammatory capsulation in soft tissue peri-implants in a rat model. Conclusion Incorporating a silver-embedded SNT array onto the implant surface demonstrated robust antibacterial properties, impeccable cytocompatibility, exceptional osteogenic activity, and the potential to prevent inflammatory encapsulation around the implant site. The Silver-PIII modification strategy emerges as a highly promising approach for surface applications in endosseous implants and trans-gingival implant abutments.

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The integration of peri-implant soft tissues around zirconia abutments: Challenges and strategies

Cited by 7 publications

References 175 publications

Soft and Hard Tissue Integration around Percutaneous Bone-Anchored Titanium Prostheses: Toward Achieving Holistic Biointegration

Soft and Hard Tissue Integration around Percutaneous Bone-Anchored Titanium Prostheses: Toward Achieving Holistic Biointegration

Silk fibroin microgrooved zirconia surfaces improve connective tissue sealing through mediating glycolysis of fibroblasts

Biocompatible Nanostructured Silver-Incorporated Implant Surfaces Show Effective Antibacterial, Osteogenic, and Anti-Inflammatory Effects in vitro and in Rat Model

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