RESUMEN
Implant-associated infection (IAI) has become an intractable challenge in clinic. The healing of IAI is a complex physiological process involving a series of spatiotemporal connected events. However, existing titanium-based implants in clinic suffer from poor antibacterial effect and single function. Herein, a versatile surface platform based on the presentation of sequential function is developed. Fabrication of titania nanotubes and poly-γ-glutamic acid (γ-PGA) achieves the efficient incorporation of silver ions (Ag+) and the pH-sensitive release in response to acidic bone infection microenvironment. The optimized PGA/Ag platform exhibits satisfactory biocompatibility and converts macrophages from pro-inflammatory M1 to pro-healing M2 phenotype during the subsequent healing stage, which creates a beneficial osteoimmune microenvironment and promotes angio/osteogenesis. Furthermore, the PGA/Ag platform mediates osteoblast/osteoclast coupling through inhibiting CCL3/CCR1 signaling. These biological effects synergistically improve osseointegration under bacterial infection in vivo, matching the healing process of IAI. Overall, the novel integrated PGA/Ag surface platform proposed in this study fulfills function cascades under pathological state and shows great potential in IAI therapy.
Asunto(s)
Antibacterianos , Ácido Poliglutámico , Plata , Titanio , Animales , Titanio/química , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Ratones , Ácido Poliglutámico/química , Ácido Poliglutámico/análogos & derivados , Plata/química , Plata/farmacología , Propiedades de Superficie , Nanotubos/química , Células RAW 264.7 , Infecciones Relacionadas con Prótesis/tratamiento farmacológico , Oseointegración/efectos de los fármacos , Osteogénesis/efectos de los fármacos , Osteoblastos/efectos de los fármacos , Osteoblastos/citología , Macrófagos/efectos de los fármacos , Macrófagos/metabolismo , Masculino , Cicatrización de Heridas/efectos de los fármacos , Prótesis e ImplantesRESUMEN
The (002) crystallographic plane-oriented hydroxyapatite (HA) and anatase TiO2 enable favorable hydrophilicity, osteogenesis, and biocorrosion resistance. Thus, the crystallographic plane control in HA coating and crystalline phase control in TiO2 is vital to affect the surface and interface bioactivity and biocorrosion resistance of titanium (Ti) implants. However, a corresponding facile and efficient fabrication method is absent to realize the HA(002) mineralization and anatase TiO2 formation on Ti. Herein, we utilized the predominant Ti(0002) plane of the fibrous-grained titanium (FG Ti) to naturally form anatase TiO2 and further achieve a (002) basal plane oriented nanoHA (nHA) film through an in situ mild hydrothermal growth strategy. The formed FG Ti-nHA(002) remarkably improved hydrophilicity, mineralization, and biocorrosion resistance. Moreover, the nHA(002) film reserved the microgroove-like topological structure on FG Ti. It could enhance osteogenic differentiation through promoted contact guidance, showing one order of magnitude higher expression of osteogenic-related genes. On the other hand, the nHA(002) film restrained the osteoclast activity by blocking actin ring formation. Based on these capacities, FG Ti-nHA(002) improved new bone growth and binding strength in rabbit femur implantation, achieving satisfactory osseointegration within 2 weeks.
Asunto(s)
Durapatita , Oseointegración , Titanio , Titanio/química , Durapatita/química , Animales , Oseointegración/efectos de los fármacos , Conejos , Osteogénesis/efectos de los fármacos , Corrosión , Ratones , Materiales Biocompatibles Revestidos/química , Materiales Biocompatibles Revestidos/farmacología , Diferenciación Celular/efectos de los fármacosRESUMEN
Clinicians who place and restore implants are always concerned about the success and longevity of the same. There are several local and systemic factors that affect osseointegration and the health of the peri-implant tissues. In this study, we review the systemic factors that can affect implant survival, osseointegration, and long-term success. The study highlights the importance of delineating, and taking into consideration these systemic factors from the planning phase to the restorative phase of dental implants. A thorough medical history, including prescription and over-the-counter medications, is vital, as there may be numerous factors that could directly or indirectly influence the prognosis of dental implants.
Asunto(s)
Implantes Dentales , Oseointegración , Humanos , Pronóstico , Oseointegración/fisiología , Fracaso de la Restauración Dental , Implantación Dental Endoósea , Factores de RiesgoRESUMEN
Currently, a new non-subtractive drilling technique, called osseodensification (OD), has been developed. It involves using specially designed drills with large negative cutting angles that rotate counterclockwise, causing expansion through plastic bone deformation, thus compacting the autologous bone to the osteotomy walls, which improves the primary stability of the implant.The present systematic review aimed to determine whether the OD technique can increase the primary stability of dental implants in the posterior maxilla region as compared to the conventional drilling (CD) technique.Five databases were searched up to June 30, 2022. The inclusion criteria embraced observational clinical studies, randomized and non-randomized controlled trials, human studies in vivo, comparing OD and CD, with the measurement of the primary stability of implants in the posterior maxilla region by means of the implant stability quotient (ISQ). The tools used to assess the risk of bias were RoB 2 and the NewcastleOttawa Scale (NOS).Seven articles met the inclusion criteria, with 4 classified as having a low risk of bias and 3 with a moderate risk of bias. The OD technique consistently demonstrated an average ISQ value of 73 KHz across all studies, whereas CD yielded an average value of 58.49 kHz (p < 0.001 for 5 articles).It can be concluded that in comparison with CD, OD improves primary stability at baseline in low-density bone, such as the maxilla.
Asunto(s)
Implantación Dental Endoósea , Implantes Dentales , Maxilar , Humanos , Maxilar/cirugía , Implantación Dental Endoósea/métodos , Oseointegración , Osteotomía/métodosRESUMEN
An advantage of treated implant surfaces is their increased degree of hydrophilicity and wettability compared with untreated, machined, smooth surfaces that are hydrophobic. The present preclinical in vivo study aimed to compare the two implant surface types, namely SLActive (Straumann, Basel, Switzerland) and nanohydroxyapatite (Hiossen, Englewood Cliffs, NJ, USA), in achieving early osseointegration. The authors hypothesised that the nanohydroxyapatite surface is comparable to SLActive for early bone-implant contact. Six male mixed foxhounds underwent mandibular premolar and first molar extraction, and the sockets healed for 42 days. The mandibles were randomised to receive implants with either SLActive (control group) or nanohydroxyapatite surfaces (test group). A total of 36 implants were placed in 6 animals, and they were sacrificed at 2 weeks (2 animals), 4 weeks (2 animals) and 6 weeks (2 animals) after implant surgery. When radiographic analysis was performed, the difference in bone level between the two groups was statistically significant at 4 weeks (P = 0.024) and 6 weeks (P = 0.008), indicating that the crestal bone level was better maintained for the test group versus the control group. The bone-implant contact was also higher for the test group at 2 (P = 0.012) and 4 weeks (P = 0.011), indicating early osseointegration. In conclusion, this study underscored the potential of implants with nanohydroxyapatite surfaces to achieve early osseointegration.
Asunto(s)
Implantes Dentales , Durapatita , Mandíbula , Oseointegración , Propiedades de Superficie , Animales , Oseointegración/efectos de los fármacos , Masculino , Durapatita/farmacología , Durapatita/química , Perros , Mandíbula/cirugía , Alveolo Dental/cirugía , Alveolo Dental/diagnóstico por imagen , Diseño de Prótesis Dental , Distribución Aleatoria , Extracción Dental , Implantación Dental Endoósea/métodos , Diente Molar/cirugía , Titanio , HumectabilidadRESUMEN
BACKGROUND: Spinal implants' longevity is crucial, but titanium alloys, while advantageous, lack strong bone integration. This study aimed to achieve better osseointegration rates by utilizing the ability of boron compounds to transform stem cells in the vertebra into osteoblasts. METHOD: Twenty male albino rabbits were divided into control (n = 10) and experimental (n = 10) groups. Control group received titanium alloy pedicle screws, while experimental group received boron-coated titanium alloy screws. Under general anesthesia, screws were inserted into the L6 and L7 lumbar spines. After 16 weeks, all animals were euthanized for histological examination. Vertebra samples underwent decalcification and H&E staining. Microscopic examination assessed osseointegration, necrosis, fibrosis, and vascularization using a triple scoring system by two blinded observers. RESULT: In the boron-coated titanium alloy group, all subjects exhibited osseointegration, with 50% showing focal, 40% moderate, and 10% complete osseointegration. In the titanium alloy group, 90% showed osseointegration (70% focal, 10% moderate, and 10% complete).The differences between the groups were not statistically significant (p = 0.302). Focal necrosis rates were similar between groups, with 50.0% in the titanium alloy and 60.0% in the boron-coated group (p = 0.653).Fibrosis was absent in the titanium alloy group but present in the boron-coated group, albeit with lower rates of focal fibrosis (20.0%). However, the difference was not statistically significant (p = 0.086).Vascularization patterns showed no significant difference between groups. CONCLUSION: Boron-coated titanium alloy pedicle screws provided osseointegration rates comparable to standard titanium screws and exhibited acceptable levels of necrosis and fibrosis. With stronger biomechanical properties, they could be a better alternative to currently used titanium screws.
Asunto(s)
Aleaciones , Boro , Oseointegración , Tornillos Pediculares , Titanio , Animales , Oseointegración/efectos de los fármacos , Conejos , Masculino , Boro/farmacología , Boro/química , Materiales Biocompatibles Revestidos , Vértebras Lumbares/cirugíaRESUMEN
The dental implant market has experienced explosive growth, owing to the widespread acceptance of implants as the core of oral rehabilitation. Clinically, achieving simultaneous anti-infective effects and rapid osseointegration is a crucial but challenging task for implants. The demand for implants with long-term broad-spectrum antibacterial and immune-osteogenic properties is growing. Existing methods are limited by a lack of safety, efficiency, short-lasting anti-infective ability, and inadequate consideration of the immunomodulatory effects on osteogenesis. Herein, a ZnO/black TiO2-x heterojunction surface structure was designed as a near-infrared (NIR) light-responsive nanofilm immobilized on a titanium (Ti) implant surface. This nanofilm introduces abundant oxygen vacancies and heterojunctions, which enhance the photothermal and photoelectric abilities of Ti implants under NIR illumination by narrowing the band gap and improving interfacial charge transfer. The "photo-thermo-electric" implant exhibits excellent broad-spectrum antibacterial efficacy against three dental pathogenic bacteria (Porphyromonas gingivalis, Fusobacterium nucleatum, and Staphylococcus aureus, >99.4%) by destroying the bacterial membrane and increasing the production of intracellular reactive oxygen species. Additionally, the implant can effectively eliminate mature multispecies biofilms and kill bacteria inside the biofilms under NIR irradiation. Meanwhile, this implant can also induce the pro-regenerative transformation of macrophages and promote osteoblast proliferation and differentiation. Moreover, in vivo results confirmed the superior antibacterial and osteoimmunomodulatory properties of this dental implant. RNA sequencing revealed that the underlying osteogenic mechanisms involve activation of the Wnt/ß-catenin signaling pathway and bone development. Overall, this versatile "photo-thermo-electric" platform endows implants with anti-infection and bone integration performance simultaneously, which holds great potential for dental implants.
Asunto(s)
Antibacterianos , Implantes Dentales , Porphyromonas gingivalis , Staphylococcus aureus , Titanio , Implantes Dentales/microbiología , Titanio/química , Titanio/farmacología , Animales , Staphylococcus aureus/efectos de los fármacos , Porphyromonas gingivalis/efectos de los fármacos , Ratones , Antibacterianos/farmacología , Antibacterianos/química , Fusobacterium nucleatum/efectos de los fármacos , Oseointegración/efectos de los fármacos , Óxido de Zinc/química , Óxido de Zinc/farmacología , Inmunomodulación/efectos de los fármacos , Especies Reactivas de Oxígeno/metabolismo , Propiedades de Superficie , Pruebas de Sensibilidad Microbiana , Osteogénesis/efectos de los fármacos , Biopelículas/efectos de los fármacos , Células RAW 264.7 , Rayos InfrarrojosRESUMEN
BACKGROUND: Commercially available osseointegrated devices for transfemoral amputees are limited in size and thus fail to meet the significant anatomical variability in the femoral medullary canal. This study aimed to develop a customized osseointegrated stem to better accommodate a variety of femoral anatomies in transfemoral amputees than off-the-shelf stems. Customization is expected to enhance cortical bone preservation and increase the stem-bone contact area, which are critical for the long-term stability and success of implants. METHODS: A customized stem (OsteoCustom) was designed based on the statistical shape variability of the medullary canal. The implantability of the OsteoCustom stem was tested via 70 computed tomography (CT) images of human femurs and compared to that of a commercial device (OFI-C) for two different resection levels. The evaluations included the volume of cortical bone removed and the percentage of stem-bone contact area for both resection levels. Statistical significance was analyzed using paired and unpaired t tests. RESULTS: The OsteoCustom stem could be virtually implanted in all 70 femurs, while the OFI-C was unsuitable in 19 cases due to insufficient cortical thickness after implantation, further emphasizing its adaptability to varying anatomical conditions. The OsteoCustom stem preserved a greater volume of cortical bone than did the OFI-C. In fact, 42% less bone was removed at the proximal resection level (3.15 cm³ vs. 5.42 cm³, p ≤ 0.0001), and 33% less at the distal resection level (2.25 cm³ vs. 3.39 cm³, p = 0.003). The stem-bone contact area was also greater for the OsteoCustom stem, particularly at the distal resection level, showing a 20% increase in contact area (52.3% vs. 32.2%, p = 0.002) compared to that of the OFI-C. CONCLUSIONS: The OsteoCustom stem performed better than the commercial stem by preserving more cortical bone and achieving a greater stem-bone contact area, especially at distal resection levels where the shape of the medullary canal exhibits more inter-subject variability. Optimal fit in the distal region is of paramount importance for ensuring the stability of osseointegrated implants. This study highlights the potential benefits of customized osseointegrated stems in accommodating a broader range of femoral anatomies, with enhanced fit in the medullary canal.
Asunto(s)
Amputados , Prótesis Anclada al Hueso , Fémur , Oseointegración , Diseño de Prótesis , Humanos , Fémur/cirugía , Fémur/diagnóstico por imagen , Masculino , Oseointegración/fisiología , Femenino , Persona de Mediana Edad , Adulto , Anciano , Miembros Artificiales , Tomografía Computarizada por Rayos X , Implantación de Prótesis/métodos , Adulto JovenRESUMEN
Bisphosphonates are widely used for the treatment of postmenopausal osteoporosis; however, they cause several long-term side effects, necessitating the investigation of local ways to improve osseointegration in compromised bone tissue. The purpose of this study was to evaluate peri-implant bone repair using implants functionalized with zoledronic acid alone (OVX ZOL group, n = 11), zoledronic acid + teriparatide (OVX ZOL + TERI group, n = 11), and zoledronic acid + ruterpy (OVX ZOL + TERPY group, n = 11) compared to the control group (OVX CONV, n = 11). Analyses included computer-assisted microtomography, qualitative histologic analysis, and real-time PCR analysis. Histologically, all functionalized surfaces improved peri-implant repair, with the OVX ZOL + TERI group standing out. Similar results were found in computerized microtomography analysis. In real-time PCR analysis, however, the OVX ZOL and OVX ZOL + TERPY groups showed better results for bone formation, with the OVX ZOL + TERPY group standing out, while there were no statistical differences between the OVX CONV and OVX ZOL + TERI groups for the genes studied at 28 postoperative days. Nevertheless, all functionalized groups showed a reduced rate of bone resorption. In short, all surface functionalization groups outperformed the control group, with overall better results for the OVX ZOL + TERI group.
Asunto(s)
Osteoporosis , Ácido Zoledrónico , Animales , Ratas , Femenino , Ácido Zoledrónico/administración & dosificación , Ácido Zoledrónico/farmacología , Osteoporosis/tratamiento farmacológico , Microtomografía por Rayos X , Oseointegración/efectos de los fármacos , Conservadores de la Densidad Ósea/administración & dosificación , Conservadores de la Densidad Ósea/farmacología , Conservadores de la Densidad Ósea/uso terapéutico , Sistemas de Liberación de Medicamentos/métodos , Difosfonatos/administración & dosificación , Osteogénesis/efectos de los fármacosRESUMEN
The inflammation causes the destroyed osseointegration at the implant-bone interface, significantly increasing the probability of implant loosening in osteoporotic patients. Currently, inhibiting the differentiation of M1 macrophages and the inflammatory response could be a solution to stabilize the microenvironment of implants. Interestingly, some natural products have anti-inflammatory and anti-polarization effects, which could be a promising candidate for stabilizing the implants' microenvironment in osteoporotic patients. This research aims to explore the inhibitory effect of Urolithin B(UB) on macrophage M1 polarization, which ameliorates inflammation, thus alleviating implant instability. We established an osteoporosis mouse model of implant loosening. The mouse tissues were taken out for morphological analysis, staining analysis, and bone metabolic index analysis. In in vitro experiments, RAW264.7 cells were polarized to M1 macrophages using lipopolysaccharide (LPS) and analyzed by immunofluorescence (IF) staining, Western blot (WB), and flow cytometry. The CSP100 plus chip experiments were used to explore the potential mechanisms behind the inhibiting effects of UB. Through observation of these experiments, UB can improve the osseointegration between the implants and femurs in osteoporotic mice and enhance the stability of implants. The UB can inhibit the differentiation of M1 macrophages and local inflammation via inhibiting the phosphorylation of VEGFR2, which can be further proved by the weakened inhibited effects of UB in macrophages with lentivirus-induced overexpression of VEGFR2. Overall, UB can specifically inhibit the activation of VEGFR2, alleviate local inflammation, and improve the stability of implants in osteoporotic mice.
Asunto(s)
Diferenciación Celular , Cumarinas , Macrófagos , Osteoporosis , Receptor 2 de Factores de Crecimiento Endotelial Vascular , Animales , Ratones , Cumarinas/farmacología , Cumarinas/uso terapéutico , Macrófagos/inmunología , Macrófagos/efectos de los fármacos , Macrófagos/metabolismo , Diferenciación Celular/efectos de los fármacos , Células RAW 264.7 , Fosforilación/efectos de los fármacos , Osteoporosis/tratamiento farmacológico , Osteoporosis/inmunología , Receptor 2 de Factores de Crecimiento Endotelial Vascular/metabolismo , Femenino , Ratones Endogámicos C57BL , Regulación hacia Abajo/efectos de los fármacos , Oseointegración/efectos de los fármacos , Antiinflamatorios/farmacología , Antiinflamatorios/uso terapéutico , Humanos , Inflamación/tratamiento farmacológico , Modelos Animales de Enfermedad , Prótesis e ImplantesRESUMEN
Bone and tooth defects can considerably affect the quality of life and health of patients, and orthopedic implants remain the primary method of addressing such defects. However, implant materials cannot coordinate with the immune microenvironment because of their biological inertness, which may lead to implant loosening or failure. Motivated by the microstructure of nacre, we engineered a biomimetic micro/nanoscale topography on a tantalum surface using a straightforward method. This comprised an organized array of tantalum nanotubes arranged in a brick wall structure, with epigallocatechin gallate acting as "mortar." The coating improved the corrosion resistance, biocompatibility, and antioxidant properties. In vitro and in vivo evaluations further confirmed that coatings can create a favorable bone immune microenvironment through the synergistic effects of mechanochemistry and enhance bone integration. This research offers a new viewpoint on the creation of sophisticated functional implants, possessing vast potential for use in the regeneration and repair of bone tissue.
Asunto(s)
Oseointegración , Tantalio , Tantalio/química , Oseointegración/efectos de los fármacos , Animales , Ratones , Materiales Biocompatibles Revestidos/química , Materiales Biocompatibles Revestidos/farmacología , Catequina/química , Catequina/análogos & derivados , Catequina/farmacología , Nanotubos/química , Inmunomodulación/efectos de los fármacos , Propiedades de Superficie , Antioxidantes/química , Antioxidantes/farmacología , HumanosRESUMEN
The aim of this animal study was to compare the primary/secondary stability and micro-CT bone and tissue volumes of implants that were immersed in Limosilactobacillus reuteri, cholecalciferol-D3 (vitamin D) and injectable platelet-rich fibrin (i-PRF) suspensions/solutions before placement in bone. 40 implants (10 in each group) were placed in the iliac crest of 5 sheep. The implants were immersed in L. reuteri, vitamin D or i-PRF solutions for five minutes before placement or left unsoaked as controls. Implant stability was determined by ISQ values and bone volume around implants was histomorphometrically analysed by micro-CT evaluation. At 4 weeks, implants in the L. reuteri group showed the highest secondary stability and 2- and 3D BV/TV values. Both L. reuteri and vitamin D immersed implants had higher osseointegration values compared to the implants in the i-PRF group and controls. There were no statistical differences between L. reuteri and vitamin D immersed implants. Within the limits of the study, the results suggest that immersing implants in L. reuteri or vitamin D suspensions/solutions before implant placement in bone may have beneficial effects on osseointegration.
Asunto(s)
Implantes Dentales , Limosilactobacillus reuteri , Oseointegración , Animales , Implantes Dentales/microbiología , Limosilactobacillus reuteri/fisiología , Ovinos , Oseointegración/efectos de los fármacos , Fibrina Rica en Plaquetas , Microtomografía por Rayos X , Colecalciferol/farmacología , Colecalciferol/administración & dosificación , Cicatrización de Heridas/efectos de los fármacosRESUMEN
The pro-inflammatory/anti-inflammatory polarized phenotypes of macrophages (M1/M2) can be used to predict the success of implant integration. Hence, activating and inducing the transformation of immunocytes that promote tissue repair appears to be a highly promising strategy for facilitating osteo-anagenesis. In a previous study, titanium implants were coated with a graphene oxide-hydroxyapatite (GO-HA) nanocomposite via electrophoretic deposition, and the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) was found to be significantly enhanced when the GO content was 2wt%. However, the effectiveness of the GO-HA nanocomposite coating in modifying the in vivo immune microenvironment still remains unclear. In this study, the effects of GO-HA coatings on osteogenesis were investigated based on the GO-HA-mediated immune regulation of macrophages. The HA-2wt%GO nanocomposite coatings exhibited good biocompatibility and favored M2 macrophage polarization. Meanwhile, they could also significantly upregulate IL-10 (anti-inflammatory factor) expression and downregulate TNF-α (pro-inflammatory factor) expression. Additionally, the microenvironment, which was established by M2 macrophages, favored the osteogenesis of BMSCs both in vivo and in vitro. These findings show that the GO-HA nanocomposite coating is a promising surface-modification material. Hence, this study provides a reference for the development of next-generation osteoimmunomodulatory biomaterials.
Asunto(s)
Materiales Biocompatibles Revestidos , Durapatita , Grafito , Macrófagos , Células Madre Mesenquimatosas , Oseointegración , Osteogénesis , Oseointegración/efectos de los fármacos , Durapatita/química , Durapatita/farmacología , Macrófagos/efectos de los fármacos , Macrófagos/inmunología , Macrófagos/metabolismo , Macrófagos/citología , Animales , Grafito/química , Grafito/farmacología , Materiales Biocompatibles Revestidos/química , Materiales Biocompatibles Revestidos/farmacología , Osteogénesis/efectos de los fármacos , Células Madre Mesenquimatosas/citología , Células Madre Mesenquimatosas/efectos de los fármacos , Ratones , Materiales Biomiméticos/química , Materiales Biomiméticos/farmacología , Prótesis e Implantes , Inmunomodulación/efectos de los fármacos , Nanocompuestos/química , Células RAW 264.7 , Diferenciación Celular/efectos de los fármacos , Titanio/química , Titanio/farmacología , MasculinoRESUMEN
Orthopedic implant failures, primarily attributed to aseptic loosening and implant site infections, pose significant challenges to patient recovery and lead to revision surgeries. Combining piezoelectric materials with ionic liquids as interfaces for orthopedic implants presents an innovative approach to addressing both issues simultaneously. In this study, films of poly(vinylidene fluoride-trifluoroethylene) (P(VDF-TrFE)) incorporated with 1-ethyl-3-methylimidazolium hydrogen sulfate ([Emim][HSO4]) ionic liquid were developed. These films exhibited strong antibacterial properties, effectively reducing biofilm formation, thereby addressing implant-related infections. Furthermore, stem cell-based differentiation assays exposed the potential of the composite materials to induce osteogenesis. Interestingly, our findings also revealed the upregulation of calcium channel expression as a result of electromechanical stimulation, pointing to a mechanistic basis for the observed biological effects. This work highlights the potential of piezoelectric materials with ionic liquids to improve the longevity and biocompatibility of orthopedic implants. Offering dual-functionality for infection prevention and bone integration, these advancements hold significant potential for advancing orthopedic implant technologies and improving patient outcomes.
Asunto(s)
Antibacterianos , Materiales Biocompatibles , Líquidos Iónicos , Oseointegración , Líquidos Iónicos/farmacología , Líquidos Iónicos/química , Antibacterianos/farmacología , Antibacterianos/química , Oseointegración/efectos de los fármacos , Materiales Biocompatibles/farmacología , Materiales Biocompatibles/química , Humanos , Biopelículas/efectos de los fármacos , Staphylococcus aureus/efectos de los fármacos , Prótesis e Implantes , Osteogénesis/efectos de los fármacosRESUMEN
Implant-associated infections and delayed osseointegration are major challenges for the clinical success of titanium implants. To enhance antibacterial effects and promote early osseointegration, we developed a synergistic photothermal (PTT)/photodynamic (PDT) therapy strategy based on near-infrared (NIR) responsive biomimetic micro/nano titanate/TiO2-X heterostructure coatings (KMNW and NaMNS) in situ constructed on the surface of titanium implants. Specifically, KMNW and NaMNS significantly enhanced photothermal conversion capabilities, achieving localized high temperatures of 48-51 °C and promoting substantial amounts of reactive oxygen species production under 808 nm irradiation. In vitro antibacterial experiments demonstrated that KMNW achieved the highest antibacterial rates against Staphylococcus aureus and Escherichia coli, at 98.78 and 98.33% respectively. Moreover, by mimicking the three-dimensional fibrous network of the extracellular matrix during bone healing, both KMNW and NaMNS markedly promoted the proliferation and osteogenic differentiation of osteoblasts. In vivo implantation studies further confirmed these findings, with KMNW and NaMNS exhibiting superior antibacterial performance under NIR irradiationâ94.45% for KMNW and 92.66% for NaMNS. Moreover, KMNW and NaMNS also significantly promoted new bone formation and improved osseointegration in vivo. This study presents a promising PTT/PDT therapeutic strategy for dentistry and orthopedics by employing NIR-responsive biomimetic coatings to combat implant-associated infection and accelerate osseointegration.
Asunto(s)
Antibacterianos , Escherichia coli , Rayos Infrarrojos , Oseointegración , Staphylococcus aureus , Titanio , Titanio/química , Titanio/farmacología , Oseointegración/efectos de los fármacos , Antibacterianos/farmacología , Antibacterianos/química , Escherichia coli/efectos de los fármacos , Animales , Staphylococcus aureus/efectos de los fármacos , Materiales Biomiméticos/química , Materiales Biomiméticos/farmacología , Materiales Biomiméticos/efectos de la radiación , Prótesis e Implantes , Fotoquimioterapia , Ratones , Terapia Fototérmica , Materiales Biocompatibles Revestidos/química , Materiales Biocompatibles Revestidos/farmacología , Especies Reactivas de Oxígeno/metabolismo , Pruebas de Sensibilidad Microbiana , Osteoblastos/efectos de los fármacos , Osteoblastos/citología , Osteogénesis/efectos de los fármacosRESUMEN
Introduction: Osseointegration stands as a pivotal concept within the realm of dental implants, signifying the intricate process through which a dental implant integrates with the adjoining bone tissue. Graphene oxide (GO) has been shown to promote osseointegration, the process by which the implant fuses with the surrounding bone. The objective of this study was to assess the osseointegrative and antimicrobial properties of GO nano coated dental implants. Methods: A systematic search was conducted using electronic databases (e.g., PubMed, Scopus, Web of Science) to identify relevant studies published. Inclusion criteria encompassed studies that evaluated the effects of GO nano coating on osseointegrative and antimicrobial characteristics of dental implants. Studies not written in English and published before 2012 were excluded. Results: The initial search yielded a total of 127 potential studies, of which six met the inclusion criteria and five were included in the review. These studies provided data on GO nano coated dental implants and their osseointegrative and antimicrobial properties. All the included studies showed moderate risk of bias. None of the studies provided information related to sample size calculation or sampling technique. Discussion: The findings from the included studies demonstrated that GO nano coating had a positive impact on osseointegrative properties of dental implants. Enhanced bone-implant contact and increased bone density were observed in animals and humans receiving GO nano coated implants. Furthermore, the antimicrobial properties of GO nano coating were found to inhibit bacterial colonization and biofilm formation on the implant surface, reducing the risk of implant-associated infections. Conclusion: The findings indicate that GO nano coating holds promise in enhancing the success rate and longevity of dental implants. However, more studies with larger sample sizes, are needed to further strengthen the evidence and determine the long-term effects of GO nano coated dental implants.
Asunto(s)
Antiinfecciosos , Materiales Biocompatibles Revestidos , Implantes Dentales , Grafito , Oseointegración , Grafito/química , Grafito/farmacología , Implantes Dentales/microbiología , Oseointegración/efectos de los fármacos , Humanos , Materiales Biocompatibles Revestidos/farmacología , Materiales Biocompatibles Revestidos/química , Antiinfecciosos/farmacología , Animales , NanoestructurasRESUMEN
Background and Objectives: Hyperglycemia is known to undermine the osteointegration process of implants. In this study, the effects of mangiferin (MF) on the post-implant osteointegration process in a type-II diabetes model were investigated molecularly and morphologically. Materials and Methods: Sprague Dawley male rats were divided into three groups: control, diabetes, and diabetes + MF. All animals were implanted in their tibia bones on day 0. At the end of the 3-month experimental period, the animals' blood and the implant area were isolated. Biochemical measurements were performed on blood samples and micro-CT, qRT-PCR, histological, and immunohistochemical measurements were performed on tibia samples. Results: MF significantly improved the increased glucose, triglyceride-VLDL levels, and liver enzymes due to diabetes. By administering MF to diabetic rats, the osteointegration percentage and bone volume increased while porosity decreased. DKK1 and BMP-2 mRNA expressions and OPN, OCN, and OSN mRNA-protein expressions increased by MF administration in diabetic rats. Additionally, while osteoblast and osteoid surface areas increased with MF, osteoclast and eroded surface areas decreased. Conclusions: The findings of our study indicate that MF will be beneficial to the bone-repairing process and osteointegration, which are impaired by type-II diabetes.
Asunto(s)
Diabetes Mellitus Experimental , Oseointegración , Ratas Sprague-Dawley , Xantonas , Animales , Xantonas/farmacología , Xantonas/uso terapéutico , Masculino , Ratas , Diabetes Mellitus Experimental/complicaciones , Diabetes Mellitus Experimental/tratamiento farmacológico , Oseointegración/efectos de los fármacos , Tibia/efectos de los fármacos , Microtomografía por Rayos X , Modelos Animales de Enfermedad , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Péptidos y Proteínas de Señalización IntercelularRESUMEN
Objective: A high sodium (HS) diet is believed to affect bone metabolism processes. Clarifying its impact on osseointegration of titanium (Ti) implants holds significant implications for postoperative dietary management of implanted patients. Methods: This investigation probed the impact of sodium ions (Na +) on neovascularization and osteogenesis around Ti implants in vivo, utilizing micro-computed tomography, hematoxylin and eosin staining, and immunohistochemical analyses. Concurrently, in vitro experiments assessed the effects of varied Na + concentrations and exposure durations on human umbilical vein endothelial cells (HUVECs) and MC3T3-E1 cells. Results: In vivo, increased dietary sodium (0.8%-6.0%) led to a substantial decline in CD34 positive HUVECs and new bone formation around Ti implants, alongside an increase in inflammatory cells. In vitro, an increase in Na + concentration (140-150 mmol/L) adversely affected the proliferation, angiogenesis, and migration of HUVECs, especially with prolonged exposure. While MC3T3-E1 cells initially exhibited less susceptibility to high Na + concentrations compared to HUVECs during short-term exposure, prolonged exposure to a HS environment progressively diminished their proliferation, differentiation, and osteogenic capabilities. Conclusion: These findings suggest that HS diet had a negative effect on the early osseointegration of Ti implants by interfering with the process of postoperative vascularized bone regeneration.
Asunto(s)
Células Endoteliales de la Vena Umbilical Humana , Oseointegración , Titanio , Animales , Oseointegración/efectos de los fármacos , Humanos , Ratones , Neovascularización Fisiológica/efectos de los fármacos , Masculino , Sodio/metabolismo , Osteogénesis/efectos de los fármacos , DietaRESUMEN
INTRODUCTION: This study reviews the feasibility of implanting active osseointegrated bone conduction devices in young children, below the prior age for FDA indication (<12 years), which has recently been reduced to 5 years. Outcomes included differences in adverse event rates and operative time between two groups (<12 and 12 years or older). MATERIALS AND METHODS: This study is a retrospective review of children receiving active osseointegrated bone conduction devices at a tertiary referral center academic hospital. One hundred and twenty-four children received 135 active osseointegrated bone conduction devices (May 2018-March 2024). RESULTS: Of 135 devices, 77 (57%) were in children <12 years (mean age (SD) = 7.9 (2.0) years, range = 4.9-11.9 years) and 58 (43%) were in 12 years or older (mean age (SD) = 15.1 (1.7) years, range = 12-18 years). Adverse events were significantly higher in the older group, occurring in 8 (10%) of 77 devices in children <12 years and 15 (26%) of 58 devices in children 12 years and older (26%) (Fisher's exact test = 0.0217 at p < 0.05). Major adverse events occurred in 5/124 (4%) patients, with 2 in patients <12 years (2/73, 3%) and 3 in children 12 and older (3/51, 6%). The proportion of major events between groups was not significantly different (Fisher's exact test = 0.4, p < 0.05). Mean surgical time was significantly less (t = -2.8799, df = 120.26, p = 0.005) in the children <12 years (mean (SD) = 66.5 (22.4) min) compared to those 12 and over (mean (SD) = 78.32 (23.1) min). CONCLUSIONS: Implantation of active osseointegrated bone conduction devices is feasible in children as young as 5 years and demonstrates low rates of complication. Further miniaturization may allow even earlier safe intervention.