Evaluation of titanium dental implants after early failure of osseointegration by means of X-ray photoelectron spectoscopy, electron microscopy and histological studies

In this work, we analysed 56 clinically failed and retrieved implants by means of scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS) and histological studies. The surface contamination was compared to that of unused control implants and with that of the same implants after cleaning in a basic medium. The surfaces of the unused implants presented considerable contamination. In particular, high levels of carbon were detected. The nature of this C was elucidated by XPS analysis of the lubricant used in the machining process. The same contamination was observed in the retrieved implants. Histological studies were carried out by means of light microscopy. Fibrosis and granulomatous lesions were detected in the tissues. XPS analysis indicated the presence of traces of other elements (Na, Ca, Zn, S, F, etc.) that were not related to impurities in cpTi. We examined a cleaning process in a basic medium that eliminates the organic components of the implant surfaces. The cleaned implants were implanted in the patients and the results were excellent. None of the implants failed in following 7 months.

Reactivity of Titanium Dental Implants in Salivary Environment in the Presence of Foods Consumed in the Republic of the Congo

In this work, samples of titanium dental implants in salivary environment in the presence of certain foods were studied. 24 samples were prepared and subjected to the reactivity of certain foods for 6, 5, 6 and 7 weeks. The ICP-MS technique was used to analyze the prepared samples. The results obtained showed no corrosion of the titanium alone in an artificial salivary medium. Significant corrosion was observed in the presence of food, which is manifested by the presence of traces of titanium in the samples.

Sensation of Balance Dysregulation Caused/Aggravated by a Collection of Electromagnetic Waves in a Dental Implant

Cell phone and personal computer users have increased considerably in recent years, particularly in more developed countries. These devices have facilitated communication on a global scale. However, there have been a number of reports of abnormalities occurring in the body due to the electromagnetic waves emitted by such electronic devices. The long lists of both general and severe symptoms, including headaches, fatigue, tinnitus, dizziness, memory loss, irregular heartbeat, and whole-body skin symptoms, have been reported that are apparently associated with the condition of electromagnetic hypersensitivity. In dentistry, titanium dental implants may be commonly associated with antenna-like activity, but the underlying mechanism remains unknown. In the current case studies, balance difficulties were found to occur when the patients had titanium dental implants. These implants seemed to be acting as antennae and collecting harmful electromagnetic waves. Further studies are required to confirm this hypothesis.

Improvement of Systemic Symptoms after Dental Implant Removal

Dental implants have spread worldwide in dentistry. The risks and complications reported are limited to local issues. However, in this case, a patient complained of systemic symptoms after dental implantation. This case report aims to demonstrate that systemic symptoms such as lumbago, shoulder stiffness, neck pain, hip joint pain, and facial pain improved after the removal of well-osseointegrated titanium implants. The results suggest that harmful electromagnetic waves received by implants affect body conditions;however, to date, the underlying mechanisms have not been identified. Therefore, further research is required.

Osteoblast integration of dental implant materials after challenge by sub-gingival pathogens: a co-culture study in vitro

Sub-gingival anaerobic pathogens can colonize an implant surface to compromise osseointegration of dental implants once the soft tissue seal around the neck of an implant is broken. In vitro evaluations of implant materials are usually done in monoculture studies involving either tissue integration or bacterial colonization. Co-culture models, in which tissue cells and bacteria battle simultaneously for estate on an implant surface, have been demonstrated to provide a better in vitro mimic of the clinical situation. Here we aim to compare the surface coverage by U2OS osteoblasts cells prior to and after challenge by two anaerobic sub-gingival pathogens in a co-culture model on differently modified titanium （Ti）, titanium-zirconium （TiZr） alloys and zirconia surfaces. Monoculture studies with either U2OS osteoblasts or bacteria were also carried out and indicated significant differences in biofilm formation between the implant materials, but interactions with U2OS osteoblasts were favourable on all materials. Adhering U2OS osteoblasts cells, however, were significantly more displaced from differently modified Ti surfaces by challenging sub-gingival pathogens than from TiZr alloys and zirconia variants. Combined with previous work employing a co-culture model consisting of human gingival fibroblasts and supra-gingival oral bacteria, results point to a different material selection to stimulate the formation of a soft tissue seal as compared to preservation of osseointegration under the unsterile conditions of the oral cavity.

Plasma cytokine profiles following subcutaneous implantation of titanium in mice

Aims and Objectives: The purpose of this study was to investigate the influence of a titanium implant on immune response in mouse by monitoring change in plasma cytokine profiles. Materials and Methods: C57BL/6 (type 1 T helper cell-predominant) and BALB/c (type 2 T helper cell-predominant) mice were used. Each type was divided into an experimental and a control group: in the former, pure titanium implants (Φ 1 mm × 1 mm) were inserted into the back of the mice subcutaneously;in the latter, the wound was sutured closed with no insertion of an implant. Blood samples were collected before implantation and at 3 hr, 24 hr, 3 d, 1 mo, and 3 mo after implantation. Levels of IL-2, IL-4, IL-5, IL-6, IL-10, IL-12, IL-13, IL-17A, IL-23, IFN-γ, TNF-α, and TGF-β1 were measured by multi-analyte enzyme-linked immunosorbent assay. Results: Baseline cytokine levels were generally higher in the BALB/c mice than in their C57BL/6 counterparts. Cytokine levels showed only slight variation after implantation of titanium in ei-ther strain. No statistically significant differences in cytokine levels were detected, except for those of IL-6 and IL-10. Conclusion: The results showed that titanium implantation induced no clear Th1-, Th2-, or Th17-mediated immune response in either Th1-or Th2-predominant mice.

Electrochemical behavior of dental implant system before and after clinical use

Electrochemical behavior of dental implant system before and after clinical use(in vivo and in vitro) was researched by using abutment and titanium fixture.To simulate an oral environment,the samples of clinically used and non-used implant systems as a working electrode were exposed to artificial saliva at(36.5±1) ℃.Electrochemical tests were carried out using a potentiostat.After electrochemical test,the corrosion morphology of each sample was investigated by FE-SEM and EDS.The corrosion potential and pitting potential of clinically used implant system are lower than those of non-used implant system,and clinically used implant system exhibits a lower range of passivation,indicating a less degree of inherent resistance against chloride ion.The polarization resistance decreases in the case of clinically used implant system,whereas,Rp for clinically non-used implant system increases compared with clinically used implant system.

I Do Biotech Dental Implants: Prospective Multicentric Study after 5 Years of Functional Loading

Introduction: I Do Biotech’s implants were developed starting in 2014. Since then, they obtained GMP and KFDA licenses for distribution in 2015. The main objective of this paper is to determine the survival rate of I Do Biotech implants five years after the first surgery. Material and Methods: 1000 implants were used on 480 prostheses across 10 clinics on 320 healthy, non-smoker and non-diabetic patients, chosen at random, of which 160 are male and 160 female, all in the age range of 30 to 50 years old. The failure rate was studied related to the patient’s gender, the length and diameter of the implant, anatomical location, the percentage of peri-implantitis, prosthodontic failures and the patient’s quality of life. Discussion: The results obtained are similar to those of Van Steenberghe D. Dieter-Busenlechner, E. Serrano Catauria and far superior to those of Sáenz Guzmán. Failure rates vary greatly from study to study due to the heterogeneity of the samples in the other research papers. Conclusion: The overall implant failure rate at 5 years is 1.7%. The factors affecting significantly the survival rate are: the implant diameter, its length and the anatomic area. Failure ratios increase significantly when the diameter or the length of the implant decreases, and when they are placed in the posterior maxilla (up to 4.3%). The rate of peri-implantitis is 5.1%. The prosthodontic failure rate is 2.91%. The improvement in quality of life and satisfaction increases with the years.

口腔种植修复中钛基底氧化锆基台的制作和力学性能

背景:随着计算机辅助设计和计算机辅助制造技术的发展,钛基底氧化锆基台因具备良好的应用优势被广泛运用于临床,但仍存在一些问题,尚缺乏共识性的设计标准。目的:综述钛基底氧化锆基台的制作方法及基台连接、穿龈设计、基台角度和粘接对钛基底氧化锆基台各类力学性能的影响。方法:检索Pub Med数据库和中国知网2010-2023年发表的相关文献,检索词为“zirconia abutment,titanium base;氧化锆基台,钛基底”,部分经典文献延长检索时间限制,通过纳入和排除标准获取相关文献,对57篇符合标准的文献进行综述。结果与结论:建议临床医生尽量选择具有抗旋结构的基台连接或是具有莫氏锥度的非抗旋连接,当运用钛基底氧化锆基台时,种植体应放置在正确的轴向角度(植体轴向向唇侧倾斜角度不超过15°或略向腭侧倾斜);当植体轴向向唇侧倾斜角度≥30°时,应当适当降低咬合力,以降低种植体、基台及修复体机械并发症和生物并发症的风险;应尽可能选择穿龈高度较高的钛基底,并且其穿龈角度不应超过40°。Multilink Hybrid Abutment可以作为氧化锆基台与钛基底口外粘结的首选粘接剂。

Characterization of Micro-arc Oxidized Titanium

The observation of the sparkling discharges during the micro-arc oxidation process in KOH aqueous electrolyte was achieved. The change of surface morphology was progressively observed and a plausible pore formation mechanism is proposed. Cell proliferation and ALP activity of micro- arc oxidized titanium was evaluated by human body derived osteoblasts and sligtaly better than those of blasted surface.

三维打印口腔修复种植体的研究进展

三维打印是计算机辅助制造的一种,通过三维打印设备,将数字化设计转化为实体。随着各种数字化手段的发展,三维打印已广泛应用于口腔修复体的制作。口腔种植义齿被称作人类第二副牙齿,以其美观、舒适等优点成为临床修复热点。目前,口腔种植体主要采用传统方法制造,三维打印可以提高种植体的个性化程度和制作效率。众多研究已证实,三维打印种植体是可行的,但在种植体设计、表面修饰等方面尚未有统一结论。本文通过阐述三维打印金属及全瓷种植体的最新研究进展,旨在带来种植体材料选择、制作工艺、表面设计及修饰等方面的思考,为三维打印种植体的进一步研究提供参考,以期更好地服务于临床。

钛网植骨联合上颌窦底提升术改善上颌磨牙区严重骨缺损病例1例

目的面对上颌磨牙区偏离牙弓曲线水平向严重缺损伴骨高度不足,本病例尝试选用钛网作为支架,联合上颌窦底提升术实现局部区域的水平向和垂直向骨增量。方法患者术前CBCT显示,26牙位处剩余骨宽度约3.3 mm,高度约4.9 mm,27牙位处剩余骨宽度约5.2 mm,高度约5.1 mm。病例治疗采用了钛网维持颊侧水平向成骨空间,采集自体骨混合人工骨植骨,并应用富血小板纤维蛋白,同时联合侧壁开窗上颌窦底提升术改善垂直向骨量。结果术后5个月,取出钛网,CBCT显示,26牙位处较术前骨宽度增加了2.0 mm,高度增加了3.2 mm;27牙位处较术前骨宽度增加了1.2 mm,高度增加了4.0 mm,获得了理想的骨增量效果。术后6个月,进行经牙槽嵴顶上颌窦底提升术和种植体植入术,种植体初期稳定性良好。术后1年,种植修复完成,CBCT显示,26牙位处较术前骨宽度增加了2.9 mm,高度增加了4.5 mm;27牙位处较术前骨宽度增加了0.9 mm,高度增加了6.6 mm,结果显示骨增量效果稳定,恢复了正常的咬合功能,并取得一定的美学效果改善。结论该病例结果表明,钛网植骨联合上颌窦底提升术可以获得较为充分稳定的骨增量效果,是一种可靠的用来改善上颌磨牙区骨量不足的方法。

钛种植体表面改性方法

钛种植体具有美观舒适、不损伤邻牙、临床效果显著等优点,广泛应用于口腔种植修复领域;但应用中存在骨结合失败、种植体周围骨吸收、种植体周围炎等问题,使其应用受到一定的限制。对钛种植体进行表面改性,在其表面制备不同的理化涂层和生物活性涂层,可以提高种植体的种植成功率,满足临床应用需求。本文从物理、化学、生物三方面对各种钛种植体表面改性方法的特点进行总结,为牙种植材料的研究和临床应用提供参考。

改良喷砂表面处理对钛牙种植体骨结合的组织学作用

研究改良喷砂表面处理对钛牙种植体骨结合的影响。方法柱状纯钛种色植分两组（光滑表面和改良喷砂表面组）进行表面处理，植于狗后肢股骨内侧髁，分别于2、4、12周取材、固定、脱钙后常规HE染色，光镜观察。结果：改良喷砂表面组与光滑表面组的骨愈合过程，均为膜内成骨，并形成完全的骨结合。二者的差别主要表现在愈合的早期（割周），改良喷砂表面组界面成骨较快，愈合中晚期差别不明显。结论：改良喷砂表面处理可以加快钛牙种植体的骨结合速度。

引导骨组织再生技术在牙种植修复中的临床应用研究

目的评价引导骨再生技术在牙种植中引导骨再生修复的方法和效果。方法对80例牙槽骨骨缺损的患者采用植Bio-Oss小牛骨粉,盖Bio-Gide膜或钛膜,进行引导骨再生,修复骨缺损并行骨内种植体周的骨增量。结果80例患者共植入90枚种植体,38例采用钛膜,42例采用Bio-Gide胶原膜;术后部份患者伤口裂开、膜暴露;Bio-Gide膜与钛膜的伤口裂开发生率分别为7.1%与21.1%。二期手术时观察膜下骨再生情况,无感染患者膜下的新骨生成较膜暴露者多,Bio-Gide胶原膜暴露后自行愈合情况较使用钛膜者理想。88枚种植体成功地完成骨整合并成功完成义齿修复,2枚种植体因钛膜暴露及感染失败。结论Bio-Gide胶原膜及钛膜皆能有效地屏蔽软组织,引导骨再生,重建牙槽骨外形;术后无伤口裂开、膜暴露者有较好的骨再生效果;与钛膜相比,Bio-Gide胶原膜更为简便易用,出现过早裂开的比率也较少。

表面陶瓷化钛种植体与骨组织结合的界面表征及机制探讨

目的:通过对种植体-骨组织界面表征的研究,评价和分析新型表面陶瓷化钛种植体(Bio-Tiimplant)的骨结合情况及机制。方法:制作犬下颌牙列部分缺损模型,设计制作相应的钛种植体,经过表面陶瓷化处理后,植入犬下颌骨,分别于3、6、12周处死动物,利用SEM对种植体表面矿物质沉积情况进行观察,同时分析其元素组成,对种植体-骨组织整体标本纵向界面进行元素线性扫描分析。采用未经表面处理的相同类型纯钛种植体作为对照。结果:Bio-Ti种植体周围新生类骨组织在3周时已有较多沉积,且与种植体结合较牢固,对少部分骨组织脱落处进行电镜观察及元素分析,种植体表面结构发生改建并且Ca、P含量明显上升,微孔内及周围可以看到颗粒状类骨质沉积物。线扫描及面扫描结果显示,从骨组织过渡到种植体的微观区域的Ca、P元素并未发生突变,提示两者之间磷酸钙成分的互相渗透与结合。结论:新型Bio-Ti表面陶瓷化纯钛种植体可以诱导体内类骨质早期沉积,与骨组织发生紧密结合,并显著缩短骨结合时间。

纯钛种植体表面的纳米改性研究

目的以纯钛试件为研究对象,采用溶胶凝胶技术处理纯钛表面以期构建一种纳米级多孔结构。方法使用溶胶凝胶法处理钛种植体表面。通过扫描电子显微镜(SEM)、X射线衍射仪(XRD)和X射线能量色散谱仪(EDX)观察对照组和纳米处理组表面的结构形貌、化学成分和元素组成。培养小鼠骨髓间质干细胞(MSC),于对照组和纳米处理组体外实验观察其生物相容性。结果 SEM下纳米处理组表面形成了纳米级多孔形貌。EDX显示纳米处理组表面元素主要为钛和氧元素,而对照组为钛元素。XRD图谱检测到纳米处理组表面的主要成分为二氧化钛。体外实验显示纳米处理组相对于对照组具有良好的生物相容性。结论溶胶凝胶法能通过简单的设备较为快速、均匀的形成纳米级粗糙多孔的二氧化钛涂层表面,构建的纳米表面涂层具有良好的生物相容性,可能成为一种前景良好的种植体表面改性的方法。

钛种植体表面润湿性控制的实验研究

首先用喷砂酸蚀法对钛种植体表面进行粗化处理,制备出具有微米-纳米双微观孔洞结构的超亲水表面。然后用等离子体氧化的工艺,制备具有超亲水性能的氧化钛表面,发现表面亲水性能随自偏压的增加先减小后增加,随处理时间的增加而减小。在360V自偏压、20 min处理时间和1 ml/min(标准状态)氧气流量时能到超亲水效果的锐钛矿二氧化钛表面。最后尝试用十二烷基三氯硅烷和分子自组装法在粗糙的氧化钛表面制备疏水表面,最大角度可达120°,利用等离子体处理和紫外光照射成功实现了表面由超亲水到疏水之间的转换。

镍钛形状记忆合金骨内植入生物安全度的深入研究

目的：观察表面处理和时间因素对镍钛形状记忆合金骨内植入后犬重要器官及组织中镍含量的影响。方法：将镍钛记忆合金牙科种植体植入犬股骨内，以表面是否复合氧化铝生物陶瓷分为复合组和镍钛组（分３个月和６个月两阶段）。另设对照组。分别测定犬肝、肾、脾及鼻咽粘膜中镍的含量，并作组织病理学观察。结果：镍钛组镍含量有随时间增高的趋势，但各器官组织有所不同；复合组镍含量明显低于镍钛组６个月时，但仍高于对照组；两组组织病理学观察均未见明显异常。结论：镍钛记忆合金表面复合生物陶瓷对控制其镍的释放有显著作用，但复合工艺需改进；本研究中镍钛记忆合金骨内植入后犬器官组织中镍含量虽升高，但未伴有明显的组织病理学改变。

计算机辅助设计下颌骨带种植体三维钛网的实验研究

目的:探讨利用计算机辅助方法,制作可用于下颌骨个体化功能性重建的修复体,为下颌骨个体化功能性修复探索新的方法。方法:首先通过CT扫描获取下颌骨断层解剖信息,然后运用三维重建、镜像及快速原型技术获得拟修复下颌骨复原实体模型,在此基础上利用铸造手段完成个体化三维钛网修复体的制作,然后将种植体与钛网相连接,构建个体化功能性修复体。结果:以CT扫描获取下颌骨断层解剖信息为基础,通过计算机辅助成功制作了带种植体的个体化钛网修复体,与相应的下颌骨标本连接匹配良好,个体化恢复了骨缺损的连续性,所带种植体为进行种植义齿修复恢复理想的咀嚼功能提供了可能。结论:在CT扫描获取下颌骨原始解剖信息的基础上,通过计算机CAD/CAM过程,能够成功构建下颌骨个体化功能性修复体,为临床个体化功能性颌骨重建提供了一种新的途径。