RESUMO
A reabilitação de maxilas atróficas representa desafio complexo, levando à busca de abordagens inovadoras. Procedimentos convencionais, como levantamento de seio maxilar, têm limitações, impulsionando o interesse em implantes zigomáticos. Contudo, complicações persistem, especialmente em áreas de concavidade acentuada. Este relato de caso visa demonstrar a eficácia de uma abordagem cirúrgica inovadora, combinando implantes zigomáticos e transnasais, para superar as limitações anatômicas e alcançar resultados estéticos e funcionais satisfatórios. Paciente de 58 anos, sexo feminino, desdentada total, foi submetida à reabilitação no Instituto Rosenvaldo Moreira, devido à atrofia maxilar pronunciada. Foram propostos dois planos de tratamento, envolvendo implantes zigomáticos e transnasais. A cirurgia, realizada em ambiente ambulatorial sob sedação intravenosa e anestesia local, incluiu a instalação sequencial de implantes transnasais e zigomáticos, com especial atenção à usinagem do terço cervical para prevenir complicações. A abordagem cirúrgica empregada, combinando implantes zigomáticos e transnasais, revelou-se eficaz na reabilitação da maxila atrófica. A usinagem cuidadosa contribuiu para evitar complicações, evidenciando estabilidade e ausência de inflamações peri-implantares no acompanhamento de um ano. Este relato oferece uma contribuição valiosa, destacando a viabilidade e sucesso dessa abordagem inovadora em situações desafiadoras de atrofia maxilar na implantodontia.
The rehabilitation of atrophic jaws represents a complex challenge, leading to the search for innovative approaches. Conventional procedures, such as sinus lifts, have limitations, driving interest in zygomatic implants. However, complications persist, especially in areas of pronounced concavity. This case report aims to demonstrate the effectiveness of an innovative surgical approach, combining zygomatic and transnasal implants, to overcome anatomical limitations and achieve satisfactory aesthetic and functional results. A 58-year-old female patient, completely toothless, underwent rehabilitation at the Instituto Rosenvaldo Moreira, due to pronounced maxillary atrophy. Two treatment plans were proposed, involving zygomatic and transnasal implants. The surgery, performed in an outpatient setting under intravenous sedation and local anesthesia, included the sequential installation of transnasal and zygomatic implants, with special attention to machining the cervical third to prevent complications. The surgical approach used, combining zygomatic and transnasal implants, proved to be effective in the rehabilitation of the atrophic maxilla. Careful machining helped to avoid complications, demonstrating stability and absence of peri-implant inflammation in the one-year follow-up. This report offers a valuable contribution, highlighting the feasibility and success of this innovative approach in challenging situations of maxillary atrophy in implant dentistry.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Reabilitação , Atrofia , Osseointegração , Resultado do Tratamento , MaxilaRESUMO
The purpose of this study was to evaluate the effect of a single dose of ionizing radiation (30 Gy) on the osseointegration of implants in the rabbit tibia. Twenty rabbits received two dental Morse-tapered junction implants and one implant in each tibia. The animals were randomly divided into two groups (n=10), non-irradiated (NoIr) and irradiated (Ir), wherein the Ir group received a single dose of 30 Gy radiation 2 weeks after implant installation. Microtomographic analyses (BV/TV) and histomorphometric assessments (BIC and BABT) were performed 4 weeks after implant installation. One-way ANOVA, Tukey's test, and Student's t-test (α=0.05) were used for data analysis. The results showed that BV/TV did not differ significantly between the Ir and NoIr groups (P = 0.071). In the histomorphometric analysis, neither BIC nor BABT showed significant differences between the NoIr and Ir groups (p>0.05). In conclusion, ionizing radiation in dental implants does not appear to interfere with osseointegration when installed prior to irradiation.
Assuntos
Implantação Dentária Endóssea , Implantes Dentários , Osseointegração , Radiação Ionizante , Distribuição Aleatória , Tíbia , Microtomografia por Raio-X , Animais , Osseointegração/efeitos da radiação , Coelhos , Tíbia/efeitos da radiação , Implantação Dentária Endóssea/métodos , Fatores de Tempo , Análise de Variância , Reprodutibilidade dos Testes , Valores de Referência , Implantes Experimentais , Masculino , Estatísticas não ParamétricasRESUMO
The inadequate osseointegration of titanium implants remains a significant challenge in orthopedics, limiting the long-term efficacy of prostheses and medical devices. It has been determined that biological aging of the titanium surface compromises the implant-bone tissue interaction due to increased hydrophobicity and accumulation of organic molecules. To address this issue, an innovative strategy has been proposed: the biofunctionalization of Ti6Al4V surfaces utilizing biomass derived from Chlorella sorokiniana UTEX 1230 and Synechococcus sp. PCC 7002. This research was structured to encompass microalgal culture optimization through biocompatibility evaluation of biofunctionalized surfaces. Biofunctionalization stages were analyzed using contact angle measurements, EDS, SEM, and cellular assays. It was observed that piranha solution activation generated a hydrophilic surface, while silanization was more efficient in samples treated for 14 h. It was found that Synechococcus sp. PCC 7002 presented a higher biomass concentration on the surface compared to C. sorokiniana UTEX 1230. Cytotoxicity assays revealed that the coating with Synechococcus sp. PCC 7002 was potentially non-cytotoxic, with a cell viability of 86.8%. SEM images showed a significant number of cells adhered to the treated sample. In conclusion, the potential of using microalgal biomass to biofunctionalize titanium surfaces has been demonstrated, offering an innovative alternative to improve implant-tissue interaction and, consequently, the osseointegration process in orthopedic applications.
Assuntos
Biomassa , Chlorella , Osseointegração , Synechococcus , Titânio , Titânio/química , Synechococcus/metabolismo , Synechococcus/crescimento & desenvolvimento , Chlorella/crescimento & desenvolvimento , Chlorella/metabolismo , Materiais Revestidos Biocompatíveis/química , Materiais Revestidos Biocompatíveis/farmacologia , Propriedades de Superfície , Próteses e Implantes , Ligas/química , Animais , Sobrevivência Celular/efeitos dos fármacosRESUMO
The present review summarizes the findings from human histological studies conducted over the past 20 years at the University of Guarulhos, Brazil, examining the impact of various implant surface topographies and smoking on peri-implant bone response. Seven different implant surfaces were evaluated in 90 partially or completely edentulous individuals using a total of 123 micro-implants. Histometric parameters, including bone-implant contact (BIC%), bone area within the threads (BA%), and bone density (BD), were assessed after an 8-week healing period. Scanning electron microscopy (SEM) and X-ray diffraction (XRD) analyses were also performed. Results showed that treated surfaces, regardless of the treatment type, consistently demonstrated better histometric outcomes compared to machined surfaces. Anodized surfaces and those subjected to airborne particle abrasion, followed by acid etching, exhibited higher BIC% values than machined surfaces in smoker patients. Smoking reduced BIC% around anodized implants. The presence of inflammatory cells was observed adjacent to the peri-implant soft tissue on some treated surfaces. In conclusion, implant surface topography significantly influences early bone response under unloaded conditions, with treated surfaces promoting better human bone tissue response than machined surfaces. However, smoking negatively impacts peri-implant bone healing, emphasizing the importance of smoking cessation for optimal osseointegration.
Assuntos
Implantes Dentários , Fumar , Propriedades de Superfície , Humanos , Microscopia Eletrônica de Varredura , OsseointegraçãoRESUMO
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.
Assuntos
Implantação Dentária Endóssea , Implantes Dentários , Maxila , Humanos , Implantação Dentária Endóssea/instrumentação , Implantação Dentária Endóssea/métodos , Maxila/cirurgia , Osseointegração , Osteotomia/métodosRESUMO
BACKGROUND: To verify the influence of macrogeometry with healing chambers on the osseointegration of dental implants by analyzing implant stability quotient (ISQ) and evaluate the correlation between insertion torque and ISQ insertion with different macrogeometries. METHODS: In total, 26 implants were installed in the posterior mandible of eight patients with sufficient bone height for the installation of implants measuring 3.5 mm in diameter and 9.0 mm in length. The implants were categorized according to two types of macrogeometry: a test group (GT) with 13 conical implants with healing chambers and a control group (GC) with 13 conical implants with conventional threads. To insert the implants, a bone drilling protocol was used up to a diameter of 3 mm with the last helical bur. The insertion torque of the implants was evaluated, followed by the measurement of ISQ at 0 (T-0), 7 (T-7), 14 (T-14), 21 (T-21), 28 (T-28), and 42 (T-42) days. RESULTS: The mean insertion torque was 43 Ncm in both groups, without a significant difference. Moreover, no significant difference in the ISQ values was found between the groups at different time points (p > 0.05), except at T-7 (GT = 69.87±1.89 and GC = 66.48±4.49; p = 0.01). Although there was no significant difference, ISQ median values were higher in the GT group than GC group at 28 days (GT = 67.98 and GC = 63.46; p = 0.05) and 42 days (GT = 66.12 and GC = 60.33; p = 0.09). No correlation was found between the insertion torque and ISQ insertion (p > 0.05). CONCLUSION: Furthermore, implants with a 3.5 mm diameter macrogeometry, with or without healing chambers, inserted with a drilling protocol up to 3 mm in diameter of the last helical bur, led to a similar secondary stability, with no difference in ISQ values. Although, implants with healing chamber demonstrates ascending values in the graph of ISQ, having a trend of faster osseointegration than implants without healing chambers. Both macrogeometries provide a similar primary stability to implants. TRIAL REGISTRATION: This study was registered retrospectively in ReBec (brazilian registry of clinical trials) under the number RBR-96n5×69, on the date of 19/06/2023.
Assuntos
Implantação Dentária Endóssea , Implantes Dentários , Mandíbula , Osseointegração , Torque , Humanos , Osseointegração/fisiologia , Implantação Dentária Endóssea/métodos , Masculino , Feminino , Pessoa de Meia-Idade , Mandíbula/cirurgia , Planejamento de Prótese Dentária , Adulto , Cicatrização , Idoso , Retenção em Prótese Dentária , Propriedades de SuperfícieRESUMO
OBJECTIVES: This study aimed to investigate the osseointegration of titanium (Ti) implants with micro-nano textured surfaces functionalized with strontium additions (Sr) in a pre-clinical rat tibia model. METHODOLOGY: Ti commercially pure (cp-Ti) implants were installed bilaterally in the tibia of 64 Holtzman rats, divided into four experimental groups (n=16/group): (1) Machined surface - control (C); (2) Micro-nano textured surface treatment (MN); (3) Micro-nano textured surface with Sr2+ addition (MNSr); and (4) Micro-nano textured surface with a higher complementary addition of Sr2+ (MNSr+). In total, two experimental euthanasia periods were assessed at 15 and 45 days (n=8/period). The tibia was subjected to micro-computed tomography (µ-CT), histomorphometry with the EXAKT system, removal torque (TR) testing, and gene expression analysis by PCR-Array of 84 osteogenic markers. Gene expression and protein production of bone markers were performed in an in vitro model with MC3T3-E1 cells. The surface characteristics of the implants were evaluated by scanning electron microscopy (SEM), energy-dispersive spectroscopy (EDS), and laser scanning confocal microscopy. RESULTS: SEM, confocal, and EDS analyses demonstrated the formation of uniform micro-nano textured surfaces in the MN group and Sr addition in the MNSr and MNSr+ groups. TR test indicated greater osseointegration in the 45-day period for treated surfaces. Histological analysis highlighted the benefits of the treatments, especially in cortical bone, in which an increase in bone-implant contact was found in groups MN (15 days) and MNSr (45 days) compared to the control group. Gene expression analysis of osteogenic activity markers showed modulation of various osteogenesis-related genes. According to the in vitro model, RT-qPCR and ELISA demonstrated that the treatments favored gene expression and production of osteoblastic differentiation markers. CONCLUSIONS: Micro-nano textured surface and Sr addition can effectively improve and accelerate implant osseointegration and is, therefore, an attractive approach to modifying titanium implant surfaces with significant potential in clinical practice.
Assuntos
Implantes Dentários , Osseointegração , Estrôncio , Propriedades de Superfície , Tíbia , Titânio , Microtomografia por Raio-X , Titânio/química , Osseointegração/efeitos dos fármacos , Animais , Estrôncio/farmacologia , Estrôncio/química , Fatores de Tempo , Tíbia/efeitos dos fármacos , Tíbia/cirurgia , Ratos Sprague-Dawley , Reprodutibilidade dos Testes , Teste de Materiais , Masculino , Osteogênese/efeitos dos fármacos , Microscopia Eletrônica de Varredura , Camundongos , Torque , Expressão Gênica/efeitos dos fármacos , Análise de Variância , Reação em Cadeia da Polimerase em Tempo Real , Ratos , Nanoestruturas , Valores de ReferênciaRESUMO
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.
Assuntos
Osteoporose , Ácido Zoledrônico , Animais , Ratos , Feminino , Ácido Zoledrônico/administração & dosagem , Ácido Zoledrônico/farmacologia , Osteoporose/tratamento farmacológico , Microtomografia por Raio-X , Osseointegração/efeitos dos fármacos , Conservadores da Densidade Óssea/administração & dosagem , Conservadores da Densidade Óssea/farmacologia , Conservadores da Densidade Óssea/uso terapêutico , Sistemas de Liberação de Medicamentos/métodos , Difosfonatos/administração & dosagem , Osteogênese/efeitos dos fármacosRESUMO
This study investigated the impact of adding hydroxyapatite nanoparticles to implant surfaces treated with zirconia blasting and acid etching (ZiHa), focusing on structural changes and bone healing parameters in low-density bone sites. The topographical characterization of titanium discs with a ZiHa surface and a commercially modified zirconia-blasted and acid-etched surface (Zi) was performed using scanning electron microscopy, profilometry, and surface-free energy. For the in vivo assessment, 22 female rats were ovariectomized and kept for 90 days, after which one implant from each group was randomly placed in each tibial metaphysis of the animals. Histological and immunohistochemical analyses were performed at 14 and 28 days postoperatively (decalcified lab processing), reverse torque testing was performed at 28 days, and histometry from calcified lab processing was performed at 60 days The group ZiHa promoted changes in surface morphology, forming evenly distributed pores. For bone healing, ZiHa showed a greater reverse torque, newly formed bone area, and bone/implant contact values compared to group Zi (p < 0.05; t-test). Qualitative histological and immunohistochemical analyses showed higher features of bone maturation for ZiHa on days 14 and 28. This preclinical study demonstrated that adding hydroxyapatite to zirconia-blasted and acid-etched surfaces enhanced peri-implant bone healing in ovariectomized rats. These findings support the potential for improving osseointegration of dental implants, especially in patients with compromised bone metabolism.
Assuntos
Durapatita , Nanopartículas , Osseointegração , Propriedades de Superfície , Zircônio , Zircônio/química , Animais , Durapatita/química , Durapatita/farmacologia , Feminino , Ratos , Nanopartículas/química , Osseointegração/efeitos dos fármacos , Implantes Dentários , Titânio/química , Tíbia/efeitos dos fármacos , Tíbia/cirurgia , Condicionamento Ácido do DenteRESUMO
The dental implant surface plays a crucial role in osseointegration. The topography and physicochemical properties will affect the cellular functions. In this research, four distinct titanium surfaces have been studied: machined acting (MACH), acid etched (AE), grit blasting (GBLAST), and a combination of grit blasting and subsequent acid etching (GBLAST + AE). Human amniotic mesenchymal (hAMSCs) and epithelial stem cells (hAECs) isolated from the amniotic membrane have attractive stem-cell properties. They were cultured on titanium surfaces to analyze their impact on biological behavior. The surface roughness, microhardness, wettability, and surface energy were analyzed using interferometric microscopy, Vickers indentation, and drop-sessile techniques. The GBLAST and GBLAST + AE surfaces showed higher roughness, reduced hydrophilicity, and lower surface energy with significant differences. Increased microhardness values for GBLAST and GBLAST + AE implants were attributed to surface compression. Cell viability was higher for hAMSCs, particularly on GBLAST and GBLAST + AE surfaces. Alkaline phosphatase activity enhanced in hAMSCs cultured on GBLAST and GBLAST + AE surfaces, while hAECs showed no mineralization signals. Osteogenic gene expression was upregulated in hAMSCs on GBLAST surfaces. Moreover, α2 and ß1 integrin expression enhanced in hAMSCs, suggesting a surface-integrin interaction. Consequently, hAMSCs would tend toward osteoblastic differentiation on grit-blasted surfaces conducive to osseointegration, a phenomenon not observed in hAECs.
Assuntos
Âmnio , Implantes Dentários , Propriedades de Superfície , Titânio , Humanos , Titânio/química , Âmnio/citologia , Âmnio/metabolismo , Osteogênese , Diferenciação Celular , Células Cultivadas , Osseointegração , Células-Tronco/citologia , Células-Tronco/metabolismo , Células-Tronco Mesenquimais/metabolismo , Células-Tronco Mesenquimais/citologia , Sobrevivência Celular , Fosfatase Alcalina/metabolismoRESUMO
Este estudio aborda la viabilidad y los retos inherentes al uso de barreras de polímeros impresos en 3D para la regeneración ósea guiada (en adelante, ROG) en procedimientos de implantología dental. A través del análisis exhaustivo de investigaciones y aplicaciones clínicas actuales, se evalúa detalladamente la biocompatibilidad, la funcionalidad estructural y las respuestas biológicas inducidas por estas barreras innovadoras en entornos terapéuticos. Este enfoque permite una comprensión más profunda de las interacciones osteointegrativas y las perspectivas de adaptabilidad tisular asociadas con materiales poliméricos avanzados (AU)
This scholarly investigation delineates the efficacy and inherent challenges of utilizing 3D printed polymer barriers for guided bone regeneration (GBR) in dental implantology procedures. An extensive review of current research and clinical implementations provides a critical assessment of biocompatibility, structural functionality, and the biological responses elicited by these innovative barriers within therapeutic contexts. The study delves into the osteointegrative interactions and tissue adaptability prospects facilitated by advanced polymeric materials, offering significant insights into their clinical utility.(AU)
Assuntos
Polímeros , Regeneração Óssea , Impressão Tridimensional/tendências , Materiais Biocompatíveis/uso terapêutico , Osseointegração/fisiologia , Implantação Dentária Endóssea/métodosRESUMO
The objective of this study was to analyze the influence of insertion torque, bone type, and peri-implant bone loss on implant stability quotient (ISQ) of cylindrical external hexagon (EH) and Morse Taper (MT) implants. Forty-four single implants were placed in the edentulous areas of 20 patients who met the inclusion and exclusion criteria. Immediately after implant placement (t1) and after osseointegration (four and six months for mandible and maxilla, respectively) (t2), insertion torque, resonance frequency, and peri-implant bone loss were measured using probing depths and digital periapical radiography. A significant difference was noted in the ISQ values between t1 and t2 in type III bone for EH and MT implants. No significant difference in bone loss values was observed when comparing bone types for EH or MT in all evaluated sites. Based on marginal bone loss assessed using radiography, there was no significant difference between the MT and EH groups. A positive correlation between torque and ISQ t1 value was observed for MT (correlation: 0.439; p = 0.041) and EH (correlation: 0.461; p = 0.031) implants. For EH and MT implants, the greater the insertion torque, the greater was the ISQ value (moderately positive correlation). A weak negative correlation was found between bone type and ISQ t1 for MT implants. Contrarily, no correlation was observed between bone type and ISQ t1 for EH implants. In all cases, bone loss around the implants was clinically normal.
Assuntos
Perda do Osso Alveolar , Implantação Dentária Endóssea , Osseointegração , Torque , Humanos , Masculino , Feminino , Perda do Osso Alveolar/diagnóstico por imagem , Osseointegração/fisiologia , Implantação Dentária Endóssea/métodos , Pessoa de Meia-Idade , Valores de Referência , Fatores de Tempo , Resultado do Tratamento , Estatísticas não Paramétricas , Planejamento de Prótese Dentária , Adulto , Mandíbula/cirurgia , Mandíbula/diagnóstico por imagem , Retenção em Prótese Dentária/métodos , Idoso , Análise de Frequência de Ressonância , Implantes Dentários , Maxila/cirurgia , Maxila/diagnóstico por imagem , Implantes Dentários para Um Único Dente , Reprodutibilidade dos TestesRESUMO
OBJECTIVES: to evaluate the morphological and functional characteristics of the peri-implant bone tissue that was formed during the healing process by the placement implants using two different surface treatments: hydrophilic Acqua™ (ACQ) and rough NeoPoros™ (NEO), in spontaneously hypertensive (SHR) and normotensive rats (Wistar) whether or not treated with losartan. METHODOLOGY: In total, 96 male rats (48 Wistar and 48 SHR) were divided into eight subgroups: absolute control rough (COA NEO), absolute control hydrophilic (COA ACQ), losartan control rough (COL NEO), losartan control hydrophilic (COL ACQ), SHR absolute rough (SHR NEO), SHR absolute hydrophilic (SHR ACQ), SHR losartan rough (SHRL NEO), and SHR losartan hydrophilic (SHRL ACQ). The rats medicated with losartan received daily doses of the medication. NeoPoros™ and Acqua™ implants were installed in the tibiae of the rats. After 14 and 42 days of the surgery, the fluorochromes calcein and alizarin were injected in the rats. The animals were euthanized 67 days after treatment. The collected samples were analyzed by immunohistochemistry, biomechanics, microcomputerized tomography, and laser confocal scanning microscopy analysis. RESULTS: The osteocalcin (OC) and vascular endothelium growth factor (VEGF) proteins had moderate expression in the SHRL ACQ subgroup. The same subgroup also had the highest implant removal torque. Regarding microarchitectural characteristics, a greater number of trabeculae was noted in the control animals that were treated with losartan. In the bone mineralization activity, it was observed that the Acqua™ surface triggered higher values of MAR (mineral apposition rate) in the COA, COL, and SHRL groups (p<0.05). CONCLUSION: the two implant surface types showed similar responses regarding the characteristics of the peri-implant bone tissue, even though the ACQ surface seems to improve the early stages of osseointegration.
Assuntos
Implantes Dentários , Losartan , Ratos Endogâmicos SHR , Ratos Wistar , Propriedades de Superfície , Microtomografia por Raio-X , Animais , Losartan/farmacologia , Masculino , Propriedades de Superfície/efeitos dos fármacos , Fatores de Tempo , Reprodutibilidade dos Testes , Imuno-Histoquímica , Interações Hidrofóbicas e Hidrofílicas , Osseointegração/efeitos dos fármacos , Resultado do Tratamento , Implantação Dentária Endóssea/métodos , Microscopia Confocal , Tíbia/efeitos dos fármacos , Tíbia/cirurgia , Análise de Variância , Fenômenos Biomecânicos , Valores de Referência , Osteocalcina/análiseRESUMO
Insufficient osseointegration of titanium-based implants is a factor conditioning their long-term success. Therefore, different surface modifications, such as multifunctional oxide coatings, calcium phosphates, and the addition of molecules such as peptides, have been developed to improve the bioactivity of titanium-based biomaterials. In this work, we investigate the behavior of human oral mucosal stem cells (hOMSCs) cultured on amorphous titanium oxide (aTiO2), surfaces designed to simulate titanium (Ti) surfaces, biofunctionalized with a novel sequence derived from cementum attachment protein (CAP-p15), exploring its impact on guiding hOMSCs towards an osteogenic phenotype. We carried out cell attachment and viability assays. Next, hOMSCs differentiation was assessed by red alizarin stain, ALP activity, and western blot analysis by evaluating the expression of RUNX2, BSP, BMP2, and OCN at the protein level. Our results showed that functionalized surfaces with CAP-p15 (1 µg ml-1) displayed a synergistic effect increasing cell proliferation and cell attachment, ALP activity, and expression of osteogenic-related markers. These data demonstrate that CAP-p15 and its interaction with aTiO2surfaces promote osteoblastic differentiation and enhanced mineralization of hOMSCs when compared to pristine samples. Therefore, CAP-p15 shows the potential to be used as a therapeutical molecule capable of inducing mineralized tissue regeneration onto titanium-based implants.
Assuntos
Adesão Celular , Diferenciação Celular , Proliferação de Células , Mucosa Bucal , Osteogênese , Células-Tronco , Titânio , Titânio/química , Humanos , Osteogênese/efeitos dos fármacos , Mucosa Bucal/citologia , Mucosa Bucal/metabolismo , Células-Tronco/citologia , Células-Tronco/metabolismo , Propriedades de Superfície , Células Cultivadas , Osteoblastos/citologia , Osteoblastos/metabolismo , Materiais Revestidos Biocompatíveis/química , Materiais Revestidos Biocompatíveis/farmacologia , Sobrevivência Celular , Osseointegração/efeitos dos fármacos , Materiais Biocompatíveis/químicaRESUMO
Finite element analysis (FEA) has been used to analyze the behavior of dental materials, mainly in implantology. However, FEA is a mechanical analysis and few studies have tried to simulate the biological characteristics of the healing process of loaded implants. This study used the rule of mixtures to simulate the biological healing process of immediate implants in an alveolus socket and bone-implant junction interface through FEA. Three-dimensional geometric models of the structures were obtained, and material properties were derived from the literature. The rule of mixtures was used to simulate the healing periods-immediate and early loading, in which the concentration of each cell type, based on in vivo studies, influenced the final elastic moduli. A 100 N occlusal load was simulated in axial and oblique directions. The models were evaluated for maximum and minimum principal strains, and the bone overload was assessed through Frost's mechanostat. There was a higher strain concentration in the healing regions and cortical bone tissue near the cervical portion. The bone overload was higher in the immediate load condition. The method used in this study may help to simulate the biological healing process and could be useful to relate FEA results to clinical practice.
Assuntos
Implantes Dentários , Módulo de Elasticidade , Análise de Elementos Finitos , Carga Imediata em Implante Dentário , Alvéolo Dental , Cicatrização , Humanos , Alvéolo Dental/fisiologia , Cicatrização/fisiologia , Fenômenos Biomecânicos , Simulação por Computador , Interface Osso-Implante/fisiologia , Estresse Mecânico , Processo Alveolar/fisiologia , Modelos Biológicos , Osseointegração/fisiologia , Força de Mordida , Análise do Estresse Dentário/métodos , Osteoblastos/fisiologia , Osso Cortical/fisiologia , Imageamento Tridimensional/métodosRESUMO
OBJECTIVE: the aim of this study was to analyze the influence of ozone therapy (OZN) on peri-implant bone repair in critical bones by installing osseointegrated implants in the tibia of ovariectomized rats. METHODOLOGY: ovariectomy was performed on 30 Wistar rats, aged six months (Rattus novergicus), and, after 90 days, osseointegrated implants were installed in each tibial metaphysis. The study groups were divided into the animals that received intraperitoneal ozone at a concentration of 700 mcg/kg - OZ Group (n=15) - and a control group that received an intraperitoneal saline solution and, for this reason, was named the SAL group (n=15). The applications for both groups occurred during the immediate post-operative period on the 2nd, 4th, 6th, 8th, 10th, and 12th day post-surgery. At various stages (14, 42, and 60 days), the animals were euthanized, and tests were performed on their tibiae. These tests include histomorphometric and immunohistochemical analyses, computerized microtomography, sampling in light-cured resin for calcified sections, and confocal microscopy. The obtained data were then analyzed using One-way ANOVA and the Shapiro-Wilk, Kruskal-Wallis, and student t-tests (P<0.05). RESULTS: our findings indicate that the OZ group (3.26±0.20 mm) showed better cellular organization and bone neoformation at 14 days (SAL group, 0.90±1.42 mm) (P=0.001). Immunohistochemistry revealed that osteocalcin labeling was moderate in the OZ group and mild in the SAL group at 14 and 42 days post-surgery. The data from the analysis of calcified tissues (microtomography, histometric, and bone dynamism analysis) at 60 days showed no statistically significant differences between the groups (P=0.32). CONCLUSION: it was concluded that ozone therapy anticipated the initial phases of the peri-implant bone repair process.
Assuntos
Implantes Dentários , Osseointegração , Feminino , Ratos , Animais , Humanos , Ratos Wistar , Osteocalcina/análise , Tíbia/cirurgia , Titânio , OvariectomiaRESUMO
Type 2 diabetes interferes with bone remodeling mechanisms, requiring studies to reverse this damage, and resveratrol is a polyphenol with rich properties. This study aimed to characterize the long bone morphology and peri-implant biomechanics of normoglycemic and type 2 diabetic animals treated with resveratrol. Thirty-two male Wistar rats were used and divided into normoglycemic and diabetic with or without treatment. They had the installation of implants in the tibia and treatment with oral resveratrol within 45 days. Resveratrol was responsible for weight homeostasis and decreased glycemic levels in rats with type 2 diabetes. The three-point bending testing, resveratrol showed positive effects on the biomechanics of long bones, corroborating a more resistant bone in comparison to untreated diabetics. Micro-ct revealed how bone metabolism is affected by systemic disease, decreasing bone quality. The counter-torque of normoglycemic animals showed superior osseointegration to diabetes, with no differences in the administration of the polyphenol, showing the sovereignty of the deleterious effects of the disease when there is a tissue lesion and an inflammatory picture installed. Overall, resveratrol acted positively in the etiopathogenesis of type 2 diabetes and revealed positive effects on the strength of long bones.
Assuntos
Implantes Dentários , Diabetes Mellitus Experimental , Diabetes Mellitus Tipo 2 , Ratos , Masculino , Animais , Resveratrol/farmacologia , Ratos Wistar , Diabetes Mellitus Tipo 2/patologia , Diabetes Mellitus Experimental/patologia , Osso e Ossos , Osseointegração , Tíbia/patologia , Titânio/farmacologiaRESUMO
Zirconia implants are gaining attention as a viable alternative to titanium implants due to their comparable osseointegration development, improved soft tissue adaptation, and enhanced aesthetics. An encouraging avenue for improving zirconia implant properties involves the potential application of bioactive coatings to their surfaces. These coatings have shown potential for inducing hydroxyapatite formation, crucial for bone proliferation, and improving implant mechanical properties. This study aimed to evaluate the effect of coating zirconia implants with two bioactive glasses, 45S5 and BioK, on osteogenesis in vitro and osseointegration in vivo. Zirconia samples and implants were prepared using Zpex zirconia powder and blocks, respectively. The samples were divided into three groups: polished zirconia (ZRC), zirconia coated with 45S5 bioglass (Z + 45S5), and zirconia coated with BioK glass (Z + BK). Coatings were applied using a brush and sintered at 1200°C. Chemical analysis of the coatings was carried out using x-ray diffraction and Fourier Transform Infrared Spectroscopy. Surface topography and roughness were characterized using scanning electron microscopy and a roughness meter. In vitro experiments used mesenchymal cells from Wistar rat femurs, and the coated zirconia implants were found to promote cell viability, protein synthesis, alkaline phosphatase activity, and mineralization, indicating enhanced osteogenesis. In vivo experiments with 18 rats showed positive results for bone formation and osseointegration through histological and histomorphometric analysis and a push-out test. The findings indicate that bioactive glass coatings have the potential to improve cell differentiation, bone formation, and osseointegration in zirconia implants.
Assuntos
Cerâmica , Implantes Dentários , Próteses e Implantes , Zircônio , Ratos , Animais , Ratos Wistar , Osseointegração , Propriedades de Superfície , Titânio/farmacologia , Titânio/química , Materiais Revestidos Biocompatíveis/farmacologia , Materiais Revestidos Biocompatíveis/química , Microscopia Eletrônica de VarreduraRESUMO
OBJECTIVE: To evaluate the osseointegration of implants with hydrophobic (HFB) and hydrophilic (HFL) surfaces in a murine model of high-dose bisphosphonates (BPs). MATERIALS AND METHODS: Sixty-four rats were randomly allocated into four groups: control group with HFB implants (CG-HFB), control group with HFL implants (CG-HFL), BP group with HFB implants (BP-HFB), and BP group with HFL implants (BP-HFL). Animals were euthanized after 15 and 45 days (n=8). The dependent variables assessed were the removal torque (biomechanical analysis), the bone volume around the implants (%BV/TV) (microtomographic analysis), the bone-implant contact (%BIC), the bone between the threads (%BBT) (histomorphometric analysis), and the expression of bone metabolism markers (immunohistochemistry analysis). RESULTS: The CG-HFL and BP-HFL groups presented higher removal torque than the CG-HFB and BP-HFB implants. The %BIC of the CG-HFL surfaces was slightly higher than that of the CG-HFB implants. The BP-HFB and BP-HFL groups presented a higher %BIC than that of the CG-HFB and CG-HFL groups (p<0.001). BP therapy also increased the %BBT at both implant surfaces. Higher levels of ALP were observed in the matrix region of bone tissue on the HFL surfaces than on the HFB surfaces. CONCLUSION: Both surfaces enable osseointegration in rats under BP therapy. CLINICAL RELEVANCE: The study demonstrates that hydrophobic (HFB) and hydrophilic (HFL) implant surfaces can promote osseointegration in rats undergoing bisphosphonate therapy. The HFL surfaces exhibited improved biomechanical performance, higher bone-implant contact, and increased bone volume, suggesting their potential clinical relevance for implant success in individuals on bisphosphonate treatment.
Assuntos
Implantes Dentários , Ratos , Camundongos , Animais , Osteogênese , Difosfonatos/farmacologia , Modelos Animais de Doenças , Propriedades de Superfície , Titânio/química , OsseointegraçãoRESUMO
STATEMENT OF PROBLEM: The surface of titanium dental implants treated with a high-power laser has been reported to favor osseointegration, mainly by altering protein uptake. Despite the large number of articles that address the topic, the heterogeneity of methodologies and results makes an understanding of the treatment's benefits difficult, and a systematic review is needed. PURPOSE: The purpose of this systematic review was to further the knowledge on protein uptake on titanium surfaces that have undergone treatment with a high-power laser. MATERIAL AND METHODS: This review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and was registered with the Open Science Framework (OSF) (osf.io/gcbna). Searches were performed in PubMed, Scopus, Web of Science, Embase, and Google Scholar databases. The articles were selected in 2 steps by 2 independent reviewers according to the previously selected eligibility criteria. The risk of bias was analyzed by using the Joanna Briggs Institute (JBI)-adapted quasi-experimental study evaluation tool. RESULTS: The studies addressed have shown that applying a high-power laser to the implant surface, depending on its settings, generates topographical changes that can optimize the protein absorption process and thus accelerate the other biological processes. CONCLUSIONS: The studies identified in this systematic review showed that surface treatment with a high-power laser represents a promising technique with a positive influence on protein uptake and osseointegration.