RESUMEN
Multifunctional surfaces may display the potential to accelerate and promote the healing process around dental implants. However, the initial cellular biocompatibility, molecular activity, and the release of functionalized molecules from these novel surfaces require extensive investigation for clinical use. Aiming to develop and compare innovative surfaces for application in dental implants, the present study utilized titanium disks, which were treated and divided into four groups: machined (Macro); acid-etched (Micro); anodized-hydrophilic surface (TNTs); and anodized surface coated with a rifampicin-loaded polymeric layer (poly(lactide-co-glycolide), PLGA) (TNTsRIMP). The samples were characterized regarding their physicochemical properties and the cumulative release of rifampicin (RIMP), investigated at different pH values. Additionally, differentiated osteoblasts from mesenchymal cells were used for cell viability and qRT-PCR analysis. Antibacterial properties of each surface treatment were investigated against Staphylococcus epidermidis. TNTsRIMP demonstrated controlled drug release for up to 7 days in neutral pH environments. Osteogenic cell cultures indicated that all the evaluated surfaces showed biocompatibility. The TNTs group revealed up-regulated values for bone-related gene quantification in 7 days, followed by the TNTsRIMP group. Furthermore, the antibiotic-functionalized surface revealed effectiveness to inhibit S. epidermidis and stimulate promising conditions for osteogenic cell behavior. Characteristics such as nanomorphology and hydrophilicity were determinants for the up-regulated quantification of osteogenic biomarkers related to early bone maturation, encouraging application in intra-osseous implant surfaces; in addition, antibiotic-functionalized surfaces demonstrated significant higher antibacterial properties compared to the other groups. Our findings suggest that polymeric-antibiotic-loaded coating might be applied for the prevention of early infections, favoring its application in multifunctional surfaces for intra- and/or trans-mucosal components of dental implants, while, hydrophilic nanotextured surfaces promoted optimistic properties to stimulate early bone-related cell responses, favoring its application in bone-anchored surfaces.
Asunto(s)
Antibacterianos , Implantes Dentales , Antibacterianos/farmacología , Rifampin/farmacología , Propiedades de Superficie , Diferenciación Celular , Titanio/farmacología , Titanio/química , OseointegraciónRESUMEN
Surface treatments are designed to promote modified implant surfaces with positive interactions with the surrounding living tissues. However, the inadvertent early contact of these surfaces with oral fluids during surgery may lead to undesired conditions affecting osseointegration. This study aimed to investigate the possible alterations in the physico-chemical properties of modified-surfaces caused by early saliva exposure. Titanium (Ti) surfaces were exposed to three different samples of human saliva and later analyzed for protein adhesion, physico-chemical surface alterations, and osteogenic cell-viability. The results indicated that surface roughness was the most significant factor influencing saliva protein adsorption; moreover, hydrophilic surfaces had critically lost their characteristics after contact with saliva. Decreased cell viability was observed in cultures after contact with saliva. Early contact with saliva might negatively influence modified surface properties and local cell viability. Careful surgical insertion of implants with hydrophilic surfaces is recommended, particularly in sites where saliva interaction is prone to occur.
Asunto(s)
Implantes Dentales , Oseointegración , Humanos , Saliva , Propiedades de Superficie , TitanioRESUMEN
Micro and nanoscale changes allow the optimization of physico-chemical properties of titanium implant surfaces. Recently UV and plasma treatments have allowed surface hydrophilicity to take increased prominence; however, this beneficial effect is short-lived. The aim of this study is to investigate methodologies post-anodizing treatment to generate and maintain high surface hydrophilicity along with high biocompatibility. Anodized surfaces were characterized regarding physical-chemical properties. Then, surface wettability with nanomorphology was evaluated at different times and with distinct post-treatments: as deposited, with a reactive plasma and UV-light post-treatment, stored in air or deionized (DI) water. Adhesion, alkaline phosphatase (ALP) activity and bone cell viability tests were executed after the incremental treatments. The anodizing process generated a surface with TiO2 nanotubes morphology and micro-roughness. Plasma-treated surfaces resulted in the most hydrophilic samples and this property was maintained for a longer period when those were stored in DI water (angle variation of 7° to 12° in 21 days). Furthermore, plasma post-treatment changed the titanium surface crystalline phase from amorphous to anatase. Anodized surfaces modified by reactive plasma and stored in DI water suggest better hydrophilicity stability, biocompatibility, ALP activity and achievement of crystalline phase alteration, indicating future potential use on biomedical implants.
Asunto(s)
Nanotubos , Titanio , Interacciones Hidrofóbicas e Hidrofílicas , Propiedades de SuperficieRESUMEN
OBJECTIVES: This prospective cohort study estimated the effect of technical and clinical factors on mechanical complications in implant-supported fixed complete dentures (IFCDs). The patient's perception of the impact of oral rehabilitation on quality of life was assessed. MATERIAL AND METHODS: A non-probabilistic sample consisted of 88 consecutive patients treated with 94 screw-retained, metal-acrylic IFCDs. Data collection included sociodemographic variables, presence and intensity of bruxism, maximal occlusal force, opposing arch, design of the metallic framework, distribution of occlusal contacts, and quality of life (OHIP-14). IFCD-level data were analyzed using Kaplan-Meier survival analysis and Cox regression model. Quality of life data were analyzed by paired Student t test. RESULTS: During a mean follow-up of 35.1 ± 18.3 months, 16/94 IFCDs (17%) had repairable mechanical complications because of loosening/fracture of artificial teeth (n = 15) and screw loosening (n = 1). Framework design (retention pins <4 mm) was a significant risk factor for complications (HR = 11.038; p = 0.027) when adjusted for sex. Mechanical complications were not associated with sex, body mass index, thickness of the acrylic resin veneering, type of opposing arch, distribution of occlusal contacts and force, protrusion interference, presence/intensity of bruxism or maximal occlusal force. OHIP-14 total scores decreased after IFCD treatment for both patients with or without complications. CONCLUSIONS: Within the limitations of this study, the results suggest that clinical success is associated to framework design with retention pins equal or longer than 4 mm. Quality of life improved with IFCD treatment, even in patients with mechanical complications.
Asunto(s)
Prótesis Dental de Soporte Implantado/efectos adversos , Fracaso de la Restauración Dental , Dentadura Completa/efectos adversos , Anciano , Diseño de Prótesis Dental , Análisis de Falla de Equipo , Femenino , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Calidad de Vida , Radiografía Panorámica , Factores de RiesgoRESUMEN
BACKGROUND: Sinus elevation is a reliable and often-used technique. Success of implants placed in such situations, even with bone substitutes alone, prompted the authors of this study to strive for bone loss close to zero and research variables that cause higher or lower rates of resorption. The objective of this study is to evaluate survival rates and marginal bone loss (MBL) around implants placed in sites treated with maxillary sinus augmentation using anorganic bovine bone (ABB), and identify surgical and prosthetic prognostic variables. METHODS: Fifty-five implants were placed in 30 grafted maxillary sinuses in 24 patients. Periapical radiographs were evaluated immediately after implant placement (baseline), 6 months, and at the most recent follow-up. MBL was calculated from the difference between initial and final measurements, taking into account a distortion rate for each radiograph compared with original implant measurements. RESULTS: Survival rate was 98.2%, with only one implant lost (100% survival rate after loading) over a mean follow-up time of 2.0 ± 0.9 years. MBL ranged from 0 to 2.85 mm: 75.9% of mesial sites and 83.4% of distal sites showed <1 mm of MBL, whereas 35.2% of mesial sites and 37% of distal sites exhibited no bone loss. MBL was significantly (P <0.05) greater in open-flap compared with flapless surgery. CONCLUSIONS: Within the limitations of the present study, it was concluded that maxillary sinus elevation with 100% ABB gives predictable results, and that flapless surgery results in less MBL compared with traditional open-flap surgery.
Asunto(s)
Sustitutos de Huesos , Implantación Dental Endoósea , Implantes Dentales , Seno Maxilar , Pérdida de Hueso Alveolar , Animales , Bovinos , Fracaso de la Restauración Dental , Estudios de Seguimiento , Humanos , Estudios ProspectivosRESUMEN
OBJECTIVE: The aim of this study was to assess the effects of bite splint (BS) treatment termination in patients treated for temporomandibular disorder (TMD) and sleep bruxism (SB). STUDY DESIGN: This longitudinal single-cohort study assessed 30 patients (29.5 ± 7.8 years old, 86.7% women) who were successfully treated with BS for SB and TMD for 30 days to 6 months prior to termination of the use of BS. The Research Diagnostic Criteria for TMD Axes I and II, Sleep Assessment Questionnaire, Beck Depression Inventory, and BiteStrip were used to assess TMD signs and symptoms, sleep disorders, depression, and SB at baseline and after 15 days of BS disuse. RESULTS: TMD symptoms, including the disability points, characteristic pain intensity, and present pain at rest, increased significantly (P < 0.05). After 15 days of BS termination, there were no significant differences in SB and depression levels, sleep quality, and TMD signs. CONCLUSIONS: In patients with TMD and SB, BS treatment cessation is not recommended.
Asunto(s)
Ferulas Periodontales , Bruxismo del Sueño/complicaciones , Trastornos de la Articulación Temporomandibular/terapia , Adulto , Estudios de Cohortes , Femenino , Humanos , Estudios Longitudinales , Masculino , Trastornos de la Articulación Temporomandibular/complicaciones , Adulto JovenRESUMEN
PURPOSE: A before-and-after experimental clinical study was carried out with the objective of evaluating the effect of a mandibular advancement device (MAD; 75% advancement), made of a thermoplastic material, on sleep bruxism (SB) and sleep scores. MATERIALS AND METHODS: After a habituation period of 1 week, SB scores were taken at baseline and after use of the MAD for 30 days. Scores were compared using the newly developed BiteStrip, which registers the number of contractions of the unilateral masseter muscle after a 5-hour period, giving a severity score from 0 to 3 after the registrations. To assess sleep, the Sleep Assessment Questionnaire (SAQ), a screening tool with scores ranging from 0 to 68, was used before and after use of the MAD. Twenty-eight subjects (13 women, 15 men; mean age: 42.9 +/- 12.0 years) with a clinical history of SB and no spontaneous temporomandibular disorder (TMD) pain were selected. The clinical diagnosis of either moderate or severe SB was further confirmed through use of the BiteStrip (scores 2 or 3) at baseline. A 30-day follow-up period was used for evaluation. Both methods were validated against polysomnography. In addition, common signs and symptoms of TMD based on the Research Diagnostic Criteria for Temporomandibular Disorders were also evaluated before and after use to assess the side effects of the MAD. RESULTS: There was a statistically significant improvement in both SB and sleep scores based on the BiteStrip and the SAQ (Wilcoxon signed rank and Student paired t test, P < .05). In the signs and symptoms of TMD, there was a significant reduction in temporomandibular joint sounds as well as in masseter and temporalis tenderness to palpation. None of the SB subjects experienced any breakage of the MAD. CONCLUSION: The MAD had a positive effect on SB and sleep scores, measured by the BiteStrip and the SAQ, respectively, and did not increase any traditional signs and symptoms of TMD in a 30-day evaluation period.
Asunto(s)
Avance Mandibular/instrumentación , Sistemas Microelectromecánicos/instrumentación , Bruxismo del Sueño/terapia , Sueño/fisiología , Encuestas y Cuestionarios , Adulto , Electromiografía/instrumentación , Diseño de Equipo , Dolor Facial/fisiopatología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Avance Mandibular/efectos adversos , Músculo Masetero/fisiopatología , Contracción Muscular/fisiología , Diseño de Aparato Ortodóncico , Polisomnografía , Reproducibilidad de los Resultados , Bruxismo del Sueño/fisiopatología , Sonido , Músculo Temporal/fisiopatología , Trastornos de la Articulación Temporomandibular/etiologíaRESUMEN
PURPOSE: This study evaluated the deformation of a metallic framework connected to 15 stone casts fabricated using 3 transfer techniques to determine the most accurate impression procedure. MATERIALS AND METHODS: Five stone casts were made from polyether impressions of an epoxy resin master model for each transfer technique. Group 1 samples were created by the direct splinted technique (square transfer copings splinted with carbon steel pins and autopolymerizing acrylic resin, custom tray); group 2 samples were made by the direct nonsplinted technique (square transfer copings, custom tray); and group 3 samples were fabricated using the indirect technique (tapered transfer copings, custom tray). Sixteen strain gauges were fixed on the framework to measure the degree of framework deformation for each stone cast. Pairs of strain gauges placed opposite each other constituted 1 channel to read deformation (half Wheatstone bridge). Deformation readings were collected at the 4 segments between abutments in 4 directions (anterior, posterior, superior, and inferior). Deformation data were analyzed using analysis of variance and the Tukey test at the .05 and .01 levels of significance. RESULTS: Group 1 samples allowed the most accurate reproduction of analog position compared to the samples made using the other techniques. No significant difference was found between the direct nonsplinted (group 2) and indirect (group 3) techniques. DISCUSSION: Although some studies have evaluated transfer techniques with similar methodology, this study demonstrated the most suitable strain gauge setup to record framework deformations in all directions and simultaneously offset the effects of temperature variation. CONCLUSIONS: The direct splinted technique was the most accurate transfer method for multiple abutments compared to direct nonsplinted and indirect techniques.