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.

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.

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.

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.

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。

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。

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.

口腔种植体新材料的研究进展

自骨结合理论提出以来,种植义齿在临床上得到越来越广泛的应用,已成为牙列缺损和牙列缺失的主要修复方法之一。目前,钛及钛合金材料凭借良好的机械性能和骨结合能力成为最常用的种植体材料,但临床应用中也暴露出许多不足。随着材料科学的发展,新型口腔种植体材料在理化特征和生物性能方面均得到优化,有望进一步提高种植体修复成功率。本文选取5种具有代表性的口腔种植体新材料,针对当前研究进展进行综述,以期为口腔种植领域临床和科研工作带来启发。

钛基牙种植体早期植入稳定性

钛(Ti)及其合金作为20世纪末兴起的种植体材料,具有高强度、低重量、生物相容性好等优势,随着种植体技术的快速发展以及临床上需求的不断增加,Ti种植体迅速且广泛的应用于骨科治疗之中,特别是针对牙缺损的修复。然而,由于骨整合速率缓慢、细菌感染以及过量活性氧累积等多种因素导致种植体早期植入稳定性差,致使植入人体后服役寿命短,成为限制牙种植体植入成功率的重要因素。因此,种植体的临床早期植入稳定性有待进一步提高。从影响临床早期植入稳定性的材料因素、生物因素以及其它因素等3个方面,综述国内外Ti基牙种植体的相关研究,以及提高临床早期植入稳定性的研究现状和发展动态,为牙种植体植入成功率的提高提供参考。

锶离子改性钛种植体表面研究进展

传统钛种植体缺乏生物活性,不能完全满足临床要求。锶离子对钛种植体表面改性可以增强其骨结合能力,减少种植体周围炎的发生。本文就锶离子改性钛种植体表面的生物性能进行综述。目前研究表明,锶离子可以通过水热处理、电化学沉积、磷酸盐化学转化、火焰喷涂、超分子自组装、磁控溅射、激光沉积和碱腐蚀等方法添加到种植体表面。锶离子改性的钛种植体表面能促进成骨、增强早期骨结合、抑制细菌生长、减少术后感染;当锶离子与其他元素如银、锌、镓、钙等掺杂时,具有更好的骨结合和抗菌效果。但关于锶离子改性钛种植体表面的研究大多为动物实验和体外实验,观察时间与种植体实际使用寿命相比较短,所得结论可能与实际临床应用有所差别,长期效果有待研究;此外,各种改性方法之间的成骨效果也需要进一步比较。未来的研究可以关注以下几点:(1)寻找高效的,可以广泛临床应用的改性方法;(2)研究如何控制种植体附近的锶离子浓度,在发挥其生物学功能的同时,减少毒副作用;(3)进行长期随访的临床实验以观察其成骨及抗菌效果。

3D打印个性化钛网在口腔种植骨增量中的研究进展

近年来,钛网因其良好的力学性能和空间维持能力在引导骨再生(guided bone regeneration,GBR)中得到应用。传统钛网需要在术中弯制和调整,不仅增加了手术时间,且弯制后的锐利边缘可能损伤软组织,增加钛网暴露的风险。个性化钛网采用增材制造(又称“3D打印”)技术制作,极大缩短了手术时间,降低了钛网的暴露率。本文对3D打印个性化钛网的性能特点、应用现状、并发症的处理与预防等相关研究进行综述,以期为个性化钛网在种植骨增量中的临床应用提供参考。

钛种植体表面Ag/HA涂层的制备及其生物活性

采用水热法制备不同含量银掺杂纳米羟基磷灰石[Ca_(10)(PO_(4))_(6)(OH)_(2)∶Ag]粉体,使用傅里叶变换红外光谱(FTIR)、透射电镜(TEM)、X射线衍射(XRD)对粉体进行表征,在口腔用钛种植体表面电泳沉积银掺杂纳米羟基磷灰石陶瓷,扫描电子显微镜(SEM)对银掺杂纳米羟基磷灰石陶瓷进行表征,体外细胞培养测试陶瓷的生物活性。结果表明,当电泳悬浮液中Ag^(+)含量为15%(质量百分比)时,制备的(Ag/HA)粉体呈棒状,长度在100~250 nm之间,直径在20 nm。小鼠骨骼肌细胞在Ag-HA涂层改性后的钛种植体表面能够有效粘附生长,表现出良好的生物活性。

3D打印个性化钛网在牙种植区骨增量中的应用

3D打印个性化钛网作为引导骨再生(guided bone regeneration,GBR)的屏障膜在牙槽骨缺损重建中应用,具有新骨重建空间维持好和可预期水平和垂直骨增量的优点。本文通过对3D打印个性化钛网厚度和孔隙度、成骨性能、设计与制作、手术方法、并发症和术后骨增量与术前预期骨增量的比较,以及3D-PITM暴露的影响因素与防治等方面进行综述。

不同口腔修复膜材料在牙种植中引导骨再生中的临床效果和安全性

目的:分析不同口腔修复膜材料应用于牙种植引导骨再生术中的临床效果与安全性。方法:选取2019年1月—2022年12月苏州市相城牙博士口腔诊所收治的行牙种植治疗的患者86例作为研究对象,随机分为对照组(n=40)与观察组(n=46)。对照组应用传统钛膜进行治疗,观察组应用海奥口腔修复膜进行治疗。比较两组牙修复情况、植骨厚度、成骨厚度、骨缺损高度、修复满意度、术后并发症。结果:观察组修复成功率高于对照组,差异有统计学意义(P=0.047);观察组植骨厚度、成骨厚度高于对照组,骨缺损高度低于对照组,差异有统计学意义(P<0.05);观察组修复满意度高于对照组,差异有统计学意义(P=0.033);观察组并发症发生率低于对照组,差异有统计学意义(P=0.003)。结论:在牙种植引导骨再生术治疗中采用海奥口腔修复膜能够取得较好的临床效果,种植修复成功率较高,能够有效促进成骨与植骨的发育成长,且术后并发症少,具有较高的安全性,患者更为满意,值得临床推广。

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。