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The development of dental implants has significantly advanced due to technological innovations aimed at improving their performance and patient outcomes. This work presents key factors influencing the success of dental implants, including osseointegration, which is the direct connection between living bone and the implant surface, and the various surface modifications that enhance this process. This review highlights the importance of surface roughness, chemical composition, and the use of bioactive coatings to promote better integration with surrounding bone tissue. Innovations such as nanotechnology, 3D printing, and smart surfaces are paving the way for more effective and personalized dental implant solutions. This review underscores the importance of ongoing research and development to improve success rates, enhance patient comfort, and reduce healing times. It focuses on creating cost-effective, reliable methods that integrate multiple functions, such as combining antibacterial and osteoconductive properties to improve overall implant performance. [ABSTRACT FROM AUTHOR]

Hypertension is a global health concern not only correlated with cardiovascular complications, but also with impaired bone metabolism, potentially affecting healing at the bone–implant interface. Losartan, an angiotensin II receptor blocker (ARB) commonly prescribed for hypertension, has shown beneficial effects on bone healing in spontaneously hypertensive rats (SHRs). However, the influence of hypertension and ARBs like losartan on the bone cellular response at the bone–implant interface remains underexplored. Methods: A total of 32 rats were included in this study: 16 SHRs, with 8 receiving losartan (30 mg/kg daily) and 8 receiving no treatment, and 16 normotensive Wistar rats, with 8 receiving losartan and 8 receiving no treatment. After one week of treatment, titanium implants were placed into the tibia of all the animals. The bone–implant interface was assessed 60 days post-implantation using micro-computed tomography (µCT) and an immunohistochemical analysis. Results: (i) The ARB treatment significantly increased the bone volume and bone–implant contact in the SHRs receiving losartan compared to the untreated SHRs. (ii) Consistent with the µCT findings, the immunohistochemistry further confirmed regular bone turnover and increased osteocalcin (OC) mineralization in the treated SHRs. In contrast, no alterations in the bone microarchitecture were noted in the Wistar rats treated with losartan. Conclusions: The results suggest that losartan, an ARB drug, improves bone volume and bone turnover at the bone–implant interface in SHRs. [ABSTRACT FROM AUTHOR]

EMG feedback improves force control of a myoelectric hand prosthesis by conveying the magnitude of the myoelectric signal back to the users via tactile stimulation. The present study aimed to test if this method can be used by a participant with a high-level amputation, and whose muscle used for prosthesis control (pectoralis major) was not intuitively related to hand function. Vibrotactile feedback was delivered to the participant's torso, while the control was tested using EMG from three different muscles. The participant completed four experimental sessions of a force-matching task with a prosthesis. The performance was evaluated by computing the target force success rate. The results of session 1 showed that the participant could effectively employ EMG feedback after only brief training. Session 2 demonstrated that EMG feedback benefited force control, increasing the success rate by approx. 30%. Finally, after proper training (sessions 3 and 4), the participant's performance when using the muscle on the amputated side was similar to that achieved with the muscles on the contralateral side. Overall, the study results indicate that EMG feedback can be used in high-level amputations, despite the extent of the injury and non-intuitive control. [ABSTRACT FROM AUTHOR]

AimMethodsResultsConclusionsWe aimed to investigate whether α-ketoglutarate (AKG) can promote autophagic activity under a peri-implant condition to enhance the osseointegration of dental implant in rats with osteoporosis (OP).Con, Model and AKG groups were established for the random allocation of thirty rats (n = 10). Their bone metabolism indicators were measured. The peri-implant bone morphology was detected by toluidine blue staining, the peri-implant bone tissue healing was detected, and the implant torque was measured.In comparison to the Con group, the bone metabolism indicators [bone volume/tissue volume ratio (BV/TV), trabecular number (Tb.N), and osseointegration index (OI)], bone-implant contact (BIC) rate, bone mass in the cancellous area, dislocation torque, protein and mRNA expressions of bone morphogenetic protein-2 (BMP-2), RUNX2 and Beclin1, and LC3II/LC3I ratio in bone tissues decreased significantly in the Model group, with a significant enlargement of trabecular space (Tb.Sp) (p < 0.05). In comparison with the Model group, the AKG group had significant increases in Tb.N, BV/TV, OI, BIC rate, bone mass in the cancellous area, dislocation torque, mRNA plus protein expressions of BMP-2, Runt-related transcription factor 2 and Beclin1, and LC3II/light chain 3I ratio in bone tissues, in addition to a significant reduction of Tb.Sp (p < 0.05).AKG may relieve the bone metabolism disorders and enhance the osteogenic differentiation and osseointegration of implants in OP rats by promoting peri-implant autophagy. [ABSTRACT FROM AUTHOR]

Background and Objective: Dental implant therapy faces challenges in patients with Type 1 and Type 2 Diabetes Mellitus (T1DM and T2DM) due to adverse effects on bone metabolism and immune response. Despite advancements, diabetic patients face higher risks of peri-implantitis and compromised osseointegration. This review assesses the impact of anti-diabetic medications on implant outcomes, offering insights to bridge the gap between animal studies and clinical practice. By evaluating pharmacotherapeutic strategies in preclinical models, this review guides future research designs to improve implant success rates in diabetic individuals. Method: A comprehensive literature review identified 21 animal studies examining the impact of anti-diabetic medications on dental and bone implants. These studies explored diabetes models, medication regimens, and designs to assess outcomes related to bone metabolism, osseointegration, and peri-implant tissue responses. The findings are systematically summarized, highlighting the scope, design, and procedures of each study. An example includes placing a dental implant in the molar region of a mouse, providing insight into preclinical approaches. Results: Twenty-one animal studies, primarily using rodents, investigate various anti-diabetic medications on dental and bone implants. Interventions include insulin, aminoguanidine, voglibose, sitagliptin, exenatide, and metformin, analyzing outcomes like bone-implant contact (BIC), bone volume (BV), and counter-torque values in T1DM and T2DM models. The impacts of these medications on implant osseointegration under diabetic conditions are detailed, with their benefits and shortcomings assessed. Discussion: The findings and challenges of existing animal studies on diabetes mellitus (DM) and implant osseointegration are presented. Despite T2DM prevalence, research primarily focuses on T1DM models due to easier experimental practicalities, limiting applicability. Inconsistent protocols in studies compromise reliability regarding anti-diabetic treatments' effectiveness on osseointegration. Standardized methodologies and long-term assessments of local drug delivery alongside systemic anti-DM treatments are crucial to manage DM-related complications in implant dentistry. Conclusion: Insulin administration in short-term T1DM animal studies enhances implant osseointegration. However, the efficacy of non-insulin medications remains inconclusive. Rigorous experimental designs are needed to address inconsistencies and assess long-term impacts. Larger-sized (e.g., porcine) animal studies across various intraoral implant scenarios are required. Future research should focus on enhancing clinical applicability and improving implant stability in evolving conditions. [ABSTRACT FROM AUTHOR]

The most time-consuming aspect of dental prosthesis installation is the osseointegration of a metal implant with bone tissue. The acceleration of this process may be achieved through the use of extracorporeal shock wave therapy. The objective of this study is to investigate the conditions for osseointegration of the second premolar implant in the mandibular segment through the use of a poroelastic model implemented in the movable cellular automaton method. The mandibular segment under consideration includes a spongy tissue layer, 600 µm in thickness, covered with a cortical layer, 400 µm in thickness, and a gum layer, 400 µm in thickness. Furthermore, the periodontal layers of the roots of the first premolar and first molar were considered, while the implant of the second premolar was situated within a shell of specific tissue that corresponded to the phase of osseointegration. The model was subjected to both physiological loading and shock wave loading across the three main phases of osseointegration. The resulting fields of hydrostatic pressure and interstitial fluid pressure were then subjected to analysis in accordance with the mechanobiological principles. The results obtained have indicated that low-intensity shock wave therapy can accelerate and promote direct osseointegration: 0.05–0.15 mJ/mm2 in the first and second phases and less than 0.05 mJ/mm2 in the third phase. In comparison to physiological loads (when bone tissue regeneration conditions are observed only around the implant distal end), shock waves offer the primary advantage of creating conditions conducive to osseointegration along the entire surface of the implant simultaneously. This can significantly influence the rate of implant integration during the initial osteoinduction phase and, most crucially, during the longest final phase of bone remodeling. [ABSTRACT FROM AUTHOR]

Nanotechnology, delving into the realm of nanometric structures, stands as a transformative force in orthopedics, reshaping diagnostics, and numerous regenerative interventions. Commencing with diagnostics, this scientific discipline empowers accurate analyses of various diseases and implant stability, heralding an era of unparalleled precision. Acting as carriers for medications, nanomaterials introduce novel therapeutic possibilities, propelling the field towards more targeted and effective treatments. In arthroplasty, nanostructural modifications to implant surfaces not only enhance mechanical properties but also promote superior osteointegration and durability. Simultaneously, nanotechnology propels tissue regeneration, with nanostructured dressings emerging as pivotal elements in accelerating wound healing. As we navigate the frontiers of nanotechnology, ongoing research illuminates promising avenues for further advancements, assuring a future where orthopedic practices are not only personalized but also highly efficient, promising a captivating journey through groundbreaking innovations and tailored patient care. [ABSTRACT FROM AUTHOR]

Periimplantitis represents an inflammatory disease of the soft and hard tissues surrounding the osseointegrated dental implant, triggering progressive damage to the alveolar bone. Cumulative data have revealed that periimplantitis plays a crucial part in implant failure. Due to the strategic roles of autophagy and its upstream coordinator, the AKT/mTOR pathway, in inflammatory responses, the crosstalk between them in the context of periimplantitis should become a key research target, as it opens up an area of interesting data with clinical significance. Therefore, in this article, we aimed to briefly review the existing data concerning the complex roles played by ROS in the interplay between the AKT/mTOR signaling pathway and autophagy in periimplantitis, in each of the main cell types involved in periimplantitis pathogenesis and evolution. Knowing how to modulate specifically the autophagic machinery in each of the cellular types involved in the healing and osseointegration steps post implant surgery can help the clinician to make the most appropriate post-surgery decisions. These decisions might be crucial in order to prevent the occurrence of periimplantitis and ensure the proper conditions for effective osseointegration, depending on patients' clinical particularities. [ABSTRACT FROM AUTHOR]

Featured Application: Magnesium-doped carbonated hydroxyapatite and tricalcium phosphate anodized coatings are applied in alpha, beta, and duplex titanium alloys to improve osseointegration. The rising demand for dental and orthopedic implants and their frequent aseptic loosening failure mode necessitate the drive to continue modifying implant surfaces to improve osseointegration outcomes. Plasma-sprayed hydroxyapatite coatings are widely used but are prone to delamination. This study involves a single-step anodization process utilizing a novel electrolyte to produce Mg-doped carbonated hydroxyapatite and tricalcium phosphate-containing coatings on four titanium alloy surfaces. XRD confirmed hydroxyapatite and tricalcium phosphate formation, with FTIR examination revealing carbonate substitutions indicative of bone-like apatite formation in each oxide. SEM analyses revealed micro- and nano-scaled surface features on each oxide. SEM and EDS analyses of the oxide coating cross-sections showed each group to be bi-layered with an inner titanium dioxide-rich layer and an outer hydroxyapatite/tricalcium phosphate-rich layer. The oxide layer adhesion quality was shown to be good on CPTi, TAV, and TiMo α + β implant alloy surfaces. Unfortunately, the anodization process also resulted in an undesirable and embrittling omega phase at the substrate–oxide interface due to the migration of molybdenum into the inner oxide. Nonetheless, the anodized coatings on the CPTi and TAV alloy substrates, which are the most widely used titanium alloys for implant applications, show much potential for improving future patient outcomes. [ABSTRACT FROM AUTHOR]

Surface coatings have been found effective to enhance the osseointegration behavior and eliminate the issues associated with titanium implants. This research aims to optimize coating material, coating thickness, and implant diameter for reduced deformation, stress, and strain (response variables) which would enhance the performance. These input variables are optimized and analyzed using response surface methodology (RSM) and finite element method. Four different coating materials, i.e., hydroxyapatite, TiO2, TiC, and gold, are selected. Coating thickness is varied from 50 to 170 μm whereas implant body diameter from 4.5 to 5 mm based on RSM's design of experiment (DOE). The designing of dental implants is done in SOLIDWORKS 2023 while simulations are done on Ansys Workbench 19.2 based on DOE. RSM indicates that coating thickness is the most significant variable in determining all the three response variables. Optimized variables are coating thickness of 170 μm, coating material of TiC, and implant diameter of 5 mm. The results from prediction model of RSM are in strong agreement with the simulation results, indicating the validity of model. In terms of mechanical behavior and stability, TiC coating shows the highest desirability (0.988). However, von Mises stress values for all coating materials are in allowable limits. [ABSTRACT FROM AUTHOR]

Plasma electrolytic oxidation (PEO) is a well‐established electrochemical method to modify titanium (Ti) surfaces for various industrial applications, including automobile, aerospace, nuclear, sports, defense, and biomedical industries. However, PEO surfaces, with their subsequent nanostructural modification to achieve enhanced antibacterial properties, osseointegration, and biocompatibility on biomedical implants are barely explored. This study investigates the combined approach of PEO and hydrothermal (HT) processes to introduce a range of nanostructures on PEO‐induced porous titania for enhanced antibacterial and improved osseointegration properties. Different fabrication conditions of combined PEO and HT process enabled the fabrication of multidimensional nano‐morphologies, such as blades, needles, belts, and grass that exhibit mechano‐bactericidal properties with enhanced biocompatibility. Antibacterial performance shows that nanostructures generated using HT on the acidic PEO process have excellent antibacterial activity, destroying 88% of E. coli and ≈99% of S. aureus colonies after 24 h incubation. All these fabricated structures show very high biomineralization ability, as confirmed by simulated body fluid (SBF) tests. This study provides valuable contributions showing the potential of low‐cost PEO technology combined with other surface engineering methods for scalable modification and improvements of titanium implants with advanced antibacterial and biointegration properties. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives Material and Methods Results Conclusion Primary stability (PS) is a key factor for promoting osseointegration and long‐term success of dental implants particularly for immediate loading protocols. Beyond the current assessments of PS, an accurate pre‐operative evaluation of PS would contribute to the improvement of surgical planning and treatment outcome. This study used biomechanical testing and homogenized finite element (hFE) analysis to objectively measure PS in the laboratory, and digitally estimate PS from prior μCT reconstructions.Thirty‐five bone samples extracted from the jaws of two donors were examined. Twenty‐two were finally evaluated for PS. After scanning of the samples with μCT, implants were inserted by two experienced surgeons, and various metrics such as μCT‐based bone volume fraction (BV/TV), insertion torque (IT), and resonance frequency analysis (RFA) were assessed to determine PS. Mechanical tests were conducted to measure ultimate force (UFexp) as an objective indicator of PS while the hFE simulations were performed to estimate this same ultimate force (UFsim).Higher correlation was found between UFsim and UFexp (R2 = 0.85) than between BV/TV and UFexp (R2 = 0.61), IT and UFexp (R2 = 0.50), and RFA and UFexp (R2 = 0.38). All variables demonstrated a statistically significant linear correlation with UFexp (p < 0.01).UFsim turns out to be a more reliable and objective indicator of PS than IT and RFA. The hFE analysis requires prior μCT reconstructions and is currently limited by numerical convergence problems. Despite these limitations, pre‐operative hFE analysis emerges as a promising tool with a higher accuracy for estimation of PS than state of care techniques. [ABSTRACT FROM AUTHOR]

With the improvement of implant design and the expansion of application scenarios, orthopedic implants have become a common surgical option for treating fractures and end‐stage osteoarthritis. Their common goal is rapidly forming and long‐term stable osseointegration. However, this fixation effect is limited by implant surface characteristics and peri‐implant bone tissue activity. Therefore, this review summarizes the strategies of interface engineering (osteogenic peptides, growth factors, and metal ions) and treatment methods (porous nanotubes, hydrogel embedding, and other load‐release systems) through research on its biological mechanism, paving the way to achieve the adaptation of both and coordination between different strategies. With the transition of the osseointegration stage, interface engineering strategies have demonstrated varying therapeutic effects. Especially, the activity of osteoblasts runs almost through the entire process of osseointegration, and their physiological activities play a dominant role in bone formation. Furthermore, diseases impacting bone metabolism exacerbate the difficulty of achieving osseointegration. This review aims to assist future research on osseointegration engineering strategies to improve implant‐bone fixation, promote fracture healing, and enhance post‐implantation recovery. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives Materials and Methods Results Conclusion Variations in transmucosal abutment contour design may affect the outcomes of implant therapy. This randomized controlled trial was primarily aimed at testing the effect that CAD/CAM zirconia abutments with either a concave or linear divergent transmucosal morphology have on peri‐implant mucosal dynamics and indicators of peri‐implant health at 1 year after final implant‐supported prosthesis insertion in the anterior maxilla.Following computer‐guided implant placement and osseointegration, eligible subjects were randomized into either the experimental (concave morphology) or the control (linear divergent morphology) group. A comprehensive set of outcomes of interest related to peri‐implant soft tissue dynamics, phenotypical features, and indicators of peri‐implant health were assessed at different time points over a 1‐year period after insertion of the final restoration.Out of 60 initially recruited subjects, a total of 54 completed the study (n = 29 in the experimental group concave/n = 25 in the control group). Overall implant survival and restoration rates between master impression and 12 months were 100% and 98.2%, respectively. Although a trend for coronal migration of the buccal mucosa zenith, gain in mucosal thickness, and increased probing depth and bleeding on probing was observed in both groups, these changes were clinically negligible, and no substantial differences were observed between study groups regardless of variations in transmucosal abutment morphology.The use of either linear divergent or concave custom CAD/CAM zirconia abutments in a screw‐retained, delayed loading approach yielded no significant differences. [ABSTRACT FROM AUTHOR]

This study investigates the effects of two parathyroid hormone (PTH) analogs, rhPTH(1-34) and dimeric R25CPTH(1-34), on bone regeneration and osseointegration in a postmenopausal osteoporosis model using beagle dogs. Twelve osteoporotic female beagles were subjected to implant surgeries and assigned to one of three groups: control, rhPTH(1-34), or dimeric R25CPTH(1-34). Bone regeneration and osseointegration were evaluated after 10 weeks using micro-computed tomographic (micro-CT), histological analyses, and serum biochemical assays. Results showed that the rhPTH(1-34) group demonstrated superior improvements in bone mineral density, trabecular architecture, and osseointegration compared to controls, while the dimeric R25CPTH(1-34) group exhibited similar, though slightly less pronounced, anabolic effects. Histological and TRAP assays indicated both PTH analogs significantly enhanced bone regeneration, especially in artificially created bone defects. The findings suggest that both rhPTH(1-34) and dimeric R25CPTH(1-34) hold potential as therapeutic agents for promoting bone regeneration and improving osseointegration around implants in osteoporotic conditions, with implications for their use in bone-related pathologies and reconstructive surgeries. [ABSTRACT FROM AUTHOR]

Background: This split-mouth, double-masked, randomized clinical trial aimed at evaluating the impact of different macro geometries and nano topographical modifications on peri-implant bone repair in smokers. Methods: Thirty-two patients who smoked at least ten cigarettes/day, with the need of a single maxillary or mandibular implant bilaterally, received two implants randomly assigned to DA - Dual Acid-Etched implants (n = 32); HCAN – healing chambers and activated nano surface (n = 32). Implant stability quotient (ISQ) was evaluated 07, 30, 60, 90, and 120 days after implant placement. Levels of bone and angiogenic markers were quantified in the peri-implant fluid after 07, 15, 30, 90, and 120 days of implant insertion. HCAN implants have a higher ISQ than DA implants at 60 days (p < 0.05). Results: PLGF levels were lower for HCAN implants than for DA implants at 07-day period (p < 0.05). Besides, HCAN implants presented higher levels of OPG at 30 days and OPN, BMP-9, FGF-1, PLGF, and VEGF at 90 days, compared to DA implants (p < 0.05). The levels of EGF were higher for HCAN implants at 15, 90, and 120 days compared with DA implants (p < 0.05). HCAN implants also showed lower levels of TNF-α at 07 days in comparison to DA implants (p < 0.05) but had higher levels of DKK1 at 30 days, while DA implants presented higher levels of this marker at 90 days (p < 0.05). Conclusion: Macro geometry and nano topographical modifications positively modulated the bone and angiogenic factors, resulting in higher production of these markers during early peri-implant bone healing and having a positive effect on implant stabilization in smokers. Trial Registration: RBR-10gjvcyt; date of registration: 06/12/2023 (Retrospectively registered). [ABSTRACT FROM AUTHOR]

Background and Objectives: Pterygoid implants represent an alternative approach for rehabilitation of posterior maxilla, and it challenges the standard procedures such as sinus lifting which has high morbidity and long healing time. There is limited data in the literature regarding the use of surgical guide to increase the success rate of pterygoid implants. Therefore, this study compared the results of pterygoid implants placed with or without surgical guide. In addition, evaluation of the effect of smoking on the success rate of pterygoid implants was a secondary aim. Methods: A prospective interventional study in which patients receiving free-hand (without surgical guide) pterygoid implants, designated as control group (12 participants, 19 implants) was compared to patients receiving guided pterygoid implants (9 participants, 11 implants). In both groups, standard two-piece implants were used. Osteointegration was tested clinically by reverse torqueing at 25 N/cm after 3 months from surgery. Results: In the free-hand group, 18 implants osseointegrated with 1 implant failed, and in the guided group, 9 implants osseointegrated with 2 implants failed. There was no statistically significant difference regarding implant success rate between the two groups. In addition, smoking did not show statistically significant correlation with implant success. Conclusion: Both groups showed high but similar success rate. As surgical guide did not increase the success rate of pterygoid implants, surgeons need to consider cost/benefit analysis of guided surgery in pterygoid implants. In addition, smoking did not result in increase of pterygoid implant failure, making its use within these patients recommended. [ABSTRACT FROM AUTHOR]

Background: Identifying patients with a strong pro-inflammatory phenotype may allow clinicians to underpin high-risk individuals based on early inflammatory marker profiles and to personalize approaches to preventative treatments. Aim: The objective of this systematic review is to synthesize the results of previous studies on osseointegration to show which pro-inflammatory cytokines and chemokines have been detected and quantified during the initial phase of osseointegration. Material and methods: PubMed, Embase, Scopus, ISI Web of Science, and Cochrane Library were searched for articles published until August 2024. A descriptive summary was produced to explain study variations, including patients' characteristics and results. The methodological quality of each included study was assessed based on Downs and Black's checklist. Results: 30 studies were selected for inclusion. In total, 710 patients received 1329 implants (an average of 1.87 implants per participant). A total of 32 biomarkers were analyzed. The overall trend observed in levels of pro-inflammatory cytokines and chemokines appears to be an early peak, followed by a progressive reduction in levels throughout the observation periods. Conclusions: The available evidence suggests that a strong expression of pro-inflammatory biomarkers is a feature of osseointegration, and an over- or underexpression of certain biomarkers could have an effect on early marginal bone levels. Several of these markers are mechanistically implicated with implant pathology; however, the prognostic value of early cytokine expression and correlation with long-term clinical outcomes requires further research. [ABSTRACT FROM AUTHOR]

Objective: The aim of this non‐inferiority randomized clinical trial was to compare the surgical and healing complications, vertical bone gain, and volumetric bone changes after vertical ridge augmentation using two different approaches: customized Ti‐reinforced d‐PTFE mesh versus customized CAD/CAM Ti‐mesh. Materials and Methods: Fifty patients with vertical bone defects were randomly treated with Ti‐reinforced d‐PTFE mesh (control group) or CAD/CAM Ti‐mesh (test group) and a mix of autogenous bone and deproteinized bovine bone matrix. Surgical and healing complication rates (SCR‐HCR), vertical bone gain (VBG), regenerated bone volume (RBV), and regeneration rates (RR and ERR) were recorded and analysed [significance level (α) of 0.05]. Results: Of the 50 patients, 48 underwent bone augmentation surgery. SCR were 4% and 12% in PTFE and Ti‐mesh, whereas HCR were 12.5% and 8.3%. VBG were 5.79 ± 1.71 mm (range: 3.2–8.8 mm) in the PTFE group and 5.18 ± 1.61 mm (range: 3.1–8.0 mm) in the Ti‐mesh group (p =.233), whereas RBV were 1.46 ± 0.48 cc and 1.26 ± 0.55. RR was 99.5% and 87.0%, demonstrating a statistically significant difference (p =.013). Finally, the values related to pseudo‐periosteum, bone density, and implant stability were similar in the two study groups. Osseointegration rates were 98.2% and 98.3%. Conclusions: This study confirmed the non‐inferiority of customized CAD/CAM titanium meshes with respect to reinforced PTFE meshes in terms of surgical and healing complications. Although PTFE meshes showed higher vertical bone gain and regeneration rates than Ti‐meshes, no significant differences were found. [ABSTRACT FROM AUTHOR]

3D-printed microporous titanium scaffolds enjoy good biointegration with the residuum's soft and bone tissues, and they promote excellent biomechanical properties in attached prostheses. Implant-associated infection, however, remains a major clinical challenge. Silver-based implant coatings can potentially reduce bacterial growth and inhibit biofilm formation, thereby reducing the risk of periprosthetic infections. In the current study, a 1-µm thick silver coating was prepared on the surface of a 3D-printed microporous titanium alloy with physical vapor deposition (PVD), with a final silver content of 1.00 ± 02 mg/cm2. Cell viability was evaluated with an MTT assay of MC3T3-E1 osteoblasts and human dermal fibroblasts cultured on the surface of the implants, and showed low cytotoxicity for cells during the 14-day follow-up period. Quantitative real-time polymerase chain reaction (RT-PCR) analysis of the relative gene expression of the extracellular matrix components (fibronectin, vitronectin, type I collagen) and cell adhesion markers (α2, α5, αV, β1 integrins) in dermal fibroblasts showed that cell adhesion was not reduced by the silver coating of the microporous implants. An RT-PCR analysis of gene expression related to osteogenic differentiation, including TGF-β1, SMAD4, osteocalcin, osteopontin, and osteonectin in MC3T3-E1 osteoblasts, demonstrated that silver coating did not reduce the osteogenic activity of cells and, to the contrary, enhanced the activity of the TGF-β signaling pathway. For representative sample S5 on day 14, the gene expression levels were 7.15 ± 0.29 (osteonectin), 6.08 ± 0.12 (osteocalcin), and 11.19 ± 0.77 (osteopontin). In conclusion, the data indicate that the silver coating of the microporous titanium implants did not reduce the biointegrative or osteoinductive properties of the titanium scaffold, a finding that argues in favor of applying this coating in designing personalized osseointegrated implants. [ABSTRACT FROM AUTHOR]

Conventional insertion torque and pull‐out tests are destructive and unsuitable for clinical bone screw fixation. This study evaluates screw stability using acoustic modal analysis (AMA) and Periotest compared to traditional methods in an ex vivo animal model. Titanium self‐tapping screws (STS) and nonself‐tapping screws (N‐STS) were implanted in the proximal tibia of 12 rabbits. Four testing methods were used to assess screw stability: peak insertion torque (PIT) during implantation, AMA for natural frequency (NF), Periotest for Periotest value (PTV), and pull‐out test for peak pullout force (PPF). Euthanization was performed at 0 (primary stability), 4, and 8 weeks (secondary stability). No significant difference in primary stability was found between STS and N‐STS except for AMA (STS: NF 2434 ± 67 Hz, N‐STS: NF 2572 ± 43 Hz; p = 0.62). Secondary stability increased significantly over time for both screw types (4‐week: NF 3687 ± 36 vs. 3408 ± 45 Hz, PTV 1.4 ± 1.6 vs. −1.5 ± 1.8, PPF 236 ± 29 vs. 220 ± 34 N; 8‐week: NF 3890 ± 39 vs. 3613 ± 31 Hz, PTV −3.2 ± 2.5 vs. −2 ± 4.3, PPF 248 ± 25 vs. 289 ± 28 N). Higher NF values for given PTV/PPF indicate potential clinical advantages. Significant differences between primary and secondary stabilities suggest osteointegration was mainly achieved in the 4‐week group. [ABSTRACT FROM AUTHOR]

Despite the success of standard antiseptic irrigation solutions in reducing periprosthetic joint infection (PJI) rates, there is still a need for more effective solutions. Synergistic use of povidone‐iodine (PI) and hydrogen peroxide (H2O2) has shown promising results; however, the optimal solution concentration balancing bactericidal activity and osseointegration remains unknown. This study aims to evaluate the impact of these antiseptic irrigation solutions on osseointegration and the bone–implant interface strength in vivo. Forty C57BL/6 mice underwent bilateral tibial implantation surgery and were randomly allocated into three groups receiving 0.3% PI, 10% PI mixed with 3% H2O2, or saline as irrigation solutions intraoperatively. Assessments were performed on postoperative Days 1 and 28, including plain radiographs, microcomputed tomography (microCT) evaluation, histological analysis, immunohistochemistry, and biomechanical pull‐out testing. No wound complications were observed. MicroCT scans revealed no differences in peri‐implant trabecular bone parameters. Biomechanical pull‐out testing showed no differences in the bone–implant interface strength across groups. Histological analysis indicated no differences in bone and bone marrow percentage areas among treatment groups. Immunohistochemical analysis demonstrated no differences among groups in peri‐implant osteocalcin, osterix, or endomucin‐positive cells. In conclusion, using either antiseptic irrigation solution showed no differences in osseointegration parameters compared to the control group, demonstrating safety and the absence of toxicity. Clinical Relevance: Dilute 0.3% povidone‐iodine and a 1:1 combination of 10% povidone‐iodine mixed with 3% hydrogen peroxide can be safely used during primary and revision total joint arthroplasty without compromising osseointegration or causing wound complications. [ABSTRACT FROM AUTHOR]

Objectives: Vitamin D deficiency may influence dental implant osseointegration unfavourably. The aim of this study was to compare dental implant stabilities of patients with different levels of vitamin D and investigate the effects of vitamin D supplementation. Materials and methods: One hundred and twenty-nine patients who underwent dental implantation were grouped regarding vitamin D levels and supplement use: Group A; vitamin D deficiency and supplement usage, Group B; insufficiency with supplement usage, Group C; insufficiency without supplements and Group D; vitamin D sufficiency. Resonance frequency analysis (RFA) measurements were performed at baseline and 3 months. Patients with vitamin D deficiency (Group A) and insufficiency (Group B) were prescribed supplements by specialists. Pearson correlation analysis was used to examine an association between vitamin D levels and implant stability. Results: Primary stability of Group D (76.34 ± 6.55) was significantly higher than Groups A, B and C at baseline (p < 0.05). At 3 months, Group C scored significantly lower than the other groups (p < 0.05). The results revealed a correlation between serum levels of vitamin D and RFA measurements at 3 months (p < 0.05). Conclusion: It was observed that high vitamin D levels influenced implant stabilities positively, as evidenced by higher Implant Stability Quotient values. Low levels of vitamin D may be associated with a decrease in implant stability. Statement of Clinical Relevance: Vitamin D, concerning its impact on bone metabolism, is currently of particular interest in implant dentistry. The lower stability scores in patients with vitamin D deficiency reinforce the recommendation of Vitamin D supplementation when treating those patients with dental implants. [ABSTRACT FROM AUTHOR]

Background: Active recruitment of osteogenic cells by secreted signaling factors, such as stromal-cell-derived factor 1 (SDF-1), has recently been proposed as a novel strategy to enhance osseointegration. However, the intrinsic importance of the SDF-1/C-X-C chemokine receptor type 4 (CXCR4) axis in promoting osseointegration is unknown. To study the role of SDF-1/CXCR4 in osseointegration, we blocked the SDF-1/CXCR4 pathway in a murine tibial implant model through repeated administrations of an antibody against SDF-1. Methods: Using our previously described murine tibial implant model (N = 24), mice were randomized into an anti-SDF-1 group and a control group (N = 12/group). Intraperitoneal injections of CXCL12/SDF-1 monoclonal antibody (84 µg/mouse) or mouse IgG1 isotype were administered on days 2, 4, 7, 10, 13, 16, 19, 22, and 25 post-surgery. Mice were euthanized 4 weeks post-surgery. Peri-implant bone mass and architecture were determined through microcomputed tomography (µ-CT). Bone implant strength was detected through implant pull-out testing. Results: Inhibition of the SDF-1/CXCR4 pathway significantly reduced host bone–implant interface strength but did not significantly change the cancellous architecture surrounding the implant. Conclusion: SDF-1/CXCR4 is an important pathway to achieve maximum implant osseointegration. However, inhibition of the pathway did not completely eliminate osseointegration. [ABSTRACT FROM AUTHOR]

The article aims to design and develop a topology-optimized endosseous cuspid tooth implant of the maxilla region. The manuscript presents a numerical analysis of the resulting von Mises stresses and effective strain resulting in the topology-optimized implant with occlusal loading of 110 N. Solid Isotropic Material with Penalization (SIMP) method is employed for topology optimization and four different models, namely model-1, model-2, model-3, and model-4, are developed based on volume reduction rates of 8%, 16%, 24%, and 32%, respectively. FEA results highlight that the maximum stress and strain in the screw increases with volume reduction rates. The comparative analyses of the resulting stresses in the compact and cancellous bone along with the strain in the screw led to the conclusion that model-1, model-2, and model-3 resulted in moderate stresses on compact and cancellous bone compared to the original model of the implant. However, the screw and bones are subjected to maximum stress and strain in the model-4. The study concludes that model-2, with 16% reduced volume and 14.2% reduced mass as compared to the original implant, may be considered as the optimized design of the model. The resulting model offers a significant reduction in the weight and volume with a minor increase in effective stress and strain without negatively impacting the functionality and bio-mechanical performance of the implant. The optimized dental implant prototype is also fabricated as a proof of concept by the Fused Deposition Modelling process. [ABSTRACT FROM AUTHOR]

Purpose: This multicenter cross‐sectional clinical study aimed to evaluate the membrane perforation rate during transcrestal sinus floor elevation (TSFE) using osseodensification (OD) burs and assess risk factors associated with the procedure. Materials and Methods: This study was conducted in six centers, following ethical standards and approved by local committees. It included patients over 18 years old missing maxillary posterior teeth with crestal residual bone height (RBH) ≥2 and ≤6 mm. Preoperative evaluations were done, including CBCT scans, to assess bone dimensions and sinus health. All centers and surgeons followed a standardized surgical protocol for TSFE using OD burs. Surgical complications, particularly sinus membrane perforations, were recorded and analyzed. Factors such as implant site, premolars or molars, as well as, healed or fresh socket, along with initial RBH were evaluated for their impact on membrane perforation rate. Descriptive statistics, χ2, and logistic regression analysis were used to analyze the data. Results: A total of 621 subjects with an average age of 57.9 years were included. Sinus lifting was performed at 670 sites, with 621 implants placed in the maxilla. The majority of sinus lifts were done in the molar region (76.87%) and in healed bone sites (74.33%). The average RBH was 5.1 mm (ranging from 2 to 7 mm). Sinus membrane perforation occurred in 49 cases (7.31%). RBH ≤3 mm posed a risk factor for sinus membrane perforations followed by RBH >3 and ≤5 mm. Tooth region and implant site were not associated as risk factors for sinus membrane perforation. Conclusion: OD drilling used for TSFE resulted in low membrane perforation rate. Challenging scenarios of severe posterior maxillary atrophy presented as risk factors for increased perforation rate. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The aim of this finite element analysis (FEA) was to investigate the distribution of von Mises stress within dental implant components, as well as trabecular and cortical bone. The study considered various bone qualities that influence cortical thickness in contact with the implant, specifically examining cortical thicknesses of 0.5, 1.5, and 3 mm, corresponding to Bergkvist's classifications IV, III, and II, respectively. A simplified 3D model of the bone was developed for the analysis. Two short implants were inserted into the model: one with a 30° inclined abutment (IA) and another positioned at a 30° angle featuring a straight abutment (II). A vertical force (120 N) was applied to the upper surface of the abutments. FEA software was employed to assess the stresses on the peri-implant tissues and the implants. The findings indicated that a reduction in cortical bone thickness results in an increase in stress within the cortical bone. For IA, the stresses recorded 32.56, 56.12, and 96.14 MPa for cortical thicknesses of 3, 1.5, and 0.5 mm, respectively. Conversely, II exhibited increased stresses across all bone qualities (52.32, 76.15, and 126.32 MPa for the same cortical thicknesses). It is advisable to avoid II in cases of poor bone quality and thin cortical due to the heightened risk of overload-induced bone resorption; however, it may be preferable to use IA in scenarios involving good bone quality and thicker cortical. [ABSTRACT FROM AUTHOR]

Background: It has been suggested that 1–2 mm of bone width at the buccal and lingual aspect is required for a successful long‐term implant outcome. Low levels of evidence support this minimum threshold of bone width. This prospective study aimed at evaluating the outcome of implants placed in alveolar ridges with limited bucco‐oral dimensions. Materials and Methods: One‐hundred implants (dia. 3.5 mm) were placed in 28 patients with narrow alveolar ridge dimensions (<4.5 mm width) without augmentation procedures and conventionally loaded. Intra‐oral radiographs were taken at implant placement and abutment connection and at 1, 2, 3, 5 and 10 years of follow‐up. At the 10‐year follow‐up (21 patients; 75 implants), full‐mouth periodontal charting was performed, and the peri‐implant keratinized tissue width and attachment type were recorded. Two calibrated periodontists analysed the peri‐implant bone changes. Results: After 10 years, all implants showed successful osseointegration and a cumulative survival rate of 100%. The implants were placed 0.85 mm ± 0.89 mm subcrestally. After 10 years, the marginal bone was located 1.59 ± 2.11 mm apical to the implant shoulder. Throughout this period of follow‐up, the mean annual marginal bone loss was 0.094 mm. Furthermore, 84% of implants in 72% of patients presented with bleeding on probing. Conclusion: After 10 years of functional loading, implants placed in alveolar ridges with limited bucco‐oral dimensions (≤4.5 mm) exhibited only minimum marginal bone loss. [ABSTRACT FROM AUTHOR]

Background and Aims: Metformin is a widely used oral agent for controlling diabetes mellitus, but it also has other therapeutic benefits for various conditions. In addition, conventional oral metformin, and topical metformin have been used in, in‐vitro studies in the treatment of acne, psoriasis, wound healing, and and so forth. While topical metformin has shown promising results in animal studies, there is limited data on its effectiveness in humans. Our study aims to summarize the clinical findings of human studies on the efficacy of topical metformin. Methods: This review followed the PRISMA standards and systematically searched multiple databases using specific keywords. The relevant articles were selected according to the inclusions and exclusions criteria. Results: Our search strategy yielded 1831 articles, after screening, 27 articles met our inclusion criteria which were: human studies, articles published before the start of the search, and topical forms of metformin. We also identified three additional relevant articles through reference checking. Therefore, our systematic review included a total of 30 articles. Conclusion: Most commonly, topical metformin has been studied in dentistry and dermatology. In dentistry, it has been found effective in treating periodontitis when used with scaling and root planning. Combining metformin with platelet‐rich fibrin can provide better benefits for furcation‐involved teeth, and coating dental implants with metformin improves osseointegration. In dermatology, studies on melasma have had inconsistent results. Topical metformin has also shown promising results in promoting hair regrowth, wound healing, and acne vulgaris, suggesting it could be a potential treatment option for these conditions. [ABSTRACT FROM AUTHOR]

Objectives: Dental implants have become a cornerstone of restorative dentistry, providing a long-lasting method for tooth replacement. The degree of osseointegration has a significant effect on biomechanical stability at the bone–implant contact (BIC), determining the continued efficacy of these implants. However, the exact consequences of changing osseointegration levels on different implant designs, especially in bones with variable densities, are not well known. Methods: This study used 3D finite element analysis (FEA) to look at the biomechanical performance of three short dental implants: BioMet 3iT3, Straumann® Standard Plus Short-Regular Neck (SPS-RN), and Straumann® Standard Plus Short-Wide Neck (SPS-WN). This paper tested the implants at four stages of osseointegration: 25%, 50%, 75%, and 100% in both high-density (bone type III) and low-density (bone type IV) cancellous bone. It also created and examined realistic CAD models under static occlusal loading conditions to assess stress distribution and major strains at the bone–implant contact. Results: The study discovered that as osseointegration increases, von Mises stress and principal strains go down significantly for all implant types. The SPS-WN implant had the lowest strain values, especially for bone with low density. These reductions demonstrate increased mechanical stability as the bone–implant interface becomes more capable of dispersing mechanical stresses, minimizing the potential for localized deformation and bone resorption. Conclusions: The results highlight the importance of achieving optimum osseointegration to reduce mechanical stress and increase the lifespan of dental implants. The SPS-WN type implant performed better in biomechanical tests than the others, especially when bone conditions were not ideal. This makes it a great choice for clinical applications that need long-term implant success. [ABSTRACT FROM AUTHOR]

This study investigated the effect of platelet-rich fibrin (PRF) on bone healing around implants placed in elevated sinus cavities. Forty New Zealand albino rabbits were divided into eight groups, based on the time of sacrifice (14 or 40 days) and the material used: blood clot (control), hydroxyapatite (HA) from bovine bone, HA combined with PRF, and PRF alone. Each group consisted of five animals (n = 5). A histological analysis measured bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO). The results showed significant increases in the BIC and BAFO values at 40 days compared to 14 days in most groups. At day 14, the HA+PRF group had higher BIC than the clot and the PRF alone groups. At 40 days, HA+PRF maintained the highest BIC across all groups (p < 0.05), though it did not show an advantage for BAFO. These findings indicate that combining HA with PRF promotes better osseointegration around implants placed immediately in maxillary sinus augmentation. Given the limited research on PRF's biological impact, these results underscore the importance of evaluating PRF's role in peri-implant healing and its potential benefits for clinical use in sinus augmentation. [ABSTRACT FROM AUTHOR]

Aims: To histologically compare osseointegration and crestal bone healing between newly introduced tapered, self‐cutting bone‐level test implants and tapered bone‐level control implants in sites with fully healed sites. Methods: Sixty‐six implants (33 test, 33 control) were placed 1 mm subcrestally in a minipig model and underwent qualitative histologic and quantitative histometric analyses after 3, 6 and 12 weeks of submerged healing. The primary and secondary outcomes were the bone‐to‐implant contact (BIC) and first bone‐to‐implant contact (fBIC). Outcomes between the test and control implants were statistically compared. Results: The BIC values of the test implants were comparable and non‐inferior over the time points studied, except for the 12 weeks time point which showed statistically significantly higher BIC values of the test (88.07 ± 5.35%) compared to the control implants (80.88 ± 7.51%) (p =.010). Similarly comparable and non‐inferior were the fBIC values, except for the 6‐week outcome, which showed statistically higher values for the test (−546.5 ± 450.80 μm) compared to the control implants (−75.7 ± 100.59 μm). fBIC results for the test implants were qualitatively more stable and consistent between test time points. Conclusion: Novel self‐cutting bone‐level test implants demonstrated superior osseointegration and similar bone levels compared to conventional bone‐level implants after a healing period of 12 weeks in healed ridges. [ABSTRACT FROM AUTHOR]

Dental implant surfaces and their unique properties can interact with the surrounding oral tissues through epigenetic cues. The present scoping review provides current perspectives on surface modifications of dental implants, their impact on the osseointegration process, and the interaction between implant surface properties and epigenetics, also in peri‐implant diseases. Findings of this review demonstrate the impact of innovative surface treatments on the epigenetic mechanisms of cells, showing promising results in the early stages of osseointegration. Dental implant surfaces with properties of hydrophilicity, nanotexturization, multifunctional coatings, and incorporated drug‐release systems have demonstrated favorable outcomes for early bone adhesion, increased antibacterial features, and improved osseointegration. The interaction between modified surface morphologies, different chemical surface energies, and/or release of molecules within the oral tissues has been shown to influence epigenetic mechanisms of the surrounding tissues caused by a physical–chemical interaction. Epigenetic changes around dental implants in the state of health and disease are different. In conclusion, emerging approaches in surface modifications for dental implants functionalized with epigenetics have great potential with a significant impact on modulating bone healing during osseointegration. [ABSTRACT FROM AUTHOR]

Nanomaterials hold significant promise for the future of orthopaedic implants due to their ability to mimic the nanoscale components of the bone, such as collagen fibrils and hydroxyapatite. Nanomaterials can regulate cell behaviour while offering mechanical strength and biocompatibility, making them ideal for bone repair and tissue regeneration. This comprehensive review explores the key existing and potential applications of nanotechnology in orthopaedics, including bone tissue engineering, drug delivery systems, systems combatting implant-related infections, and the surface preparation of implants to enhance osseointegration. These innovations are poised to revolutionise orthopaedic care by improving implant durability, reducing infection risks, and promoting bone regeneration to deliver personalised treatment and create better patient outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Balikesir Health Sciences Journal / Balıkesir Sağlık Bilimleri Dergisi is the property of Balikesir Health Sciences Journal (BAUN Health Sci J) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study investigates nanostructured titanium surfaces (Ti2 spikes) that promote the viability of osteoblasts and fibroblasts and prevent bacterial colonisation. Helium ion irradiation was adopted to produce nanometric‐sized cones on titanium. Human osteoblasts (hFOB) and human gingiva fibroblasts (hGF) were used for analysis. A viability and a cytotoxicity assay were conducted to evaluate the lactate dehydrogenase (LDH) activity and assess cell damage in Ti2 spikes compared to titanium discs with a sandblasted and acid‐etched (Ti2 SLA) surface. The antibacterial activity was investigated against Escherichia coli, Streptococcus mutans, Fusobacterium nucleatum, and Porphyromonas gingivalis. In the course of the cultivation, both hGF and hFOB demonstrated significantly reduced viability on the Ti2 spikes surface. hGF cells exhibited a slight but significant increase in LDH release. In contrast, hFOB showed reduced cytotoxicity on this surface. On the Ti2 spikes surface, hGF cells exhibited a significant reduction in gene expression of VCL, Src‐1, and ITGα5. However, the integrin subunits ITGα1 and ITGα3 showed upregulation on the Ti2 spikes surface. The Ti2 spikes surface significantly increased the expression of almost all osteogenic markers. The results of conventional culturing demonstrated a statistically significant decrease in the number of viable cells for S. mutans, F. nucleaum, and greater quantities of P. gingivalis on Ti2 spikes surface compared to control. However, no such reduction was detected for E. coli. The long‐term success of implants relies on establishing and maintaining hard and soft peri‐implant tissues. Ti2 spikes represent a novel and promising approach to enhance osseointegration and optimize biocompatibility. [ABSTRACT FROM AUTHOR]

Introduction: This preliminary in vitro study aims to evaluate the application of micro-CT in analyzing the microstructural coupling between dental implant fixtures and prosthetic abutments, with an emphasis on understanding the effectiveness and limitations of this technique in dental implantology. Materials and Methods: A search of PubMed, MEDLINE, and the Cochrane Library up to May 2024 identified eight relevant studies that examined different facets of dental implantology, such as osseointegration, implant stability, and the comparative accuracy of micro-CT versus other imaging techniques. A comparative micro-CT radiographic analysis was performed on five different implant fixtures with respective prosthetic and healing abutments, by using SkyScan1174 micro-CT. Results: The reviewed studies demonstrated that micro-CT is reliable for assessing bone quality, implant stability, and the microstructural integrity of dental implants. Micro-computed tomography (micro-CT) studies reveal bone–implant contact (BIC) ratios of 40–80%, bone volume per total volume (BV/TV) values of 20–60%, and detect microgaps as small as 0.3 µm, highlighting its high-resolution capability (5–10 µm) for detailed implant analysis. The comparative analysis of the implant fixtures analyzed the implant–abutment connection, highlighting the relevance of implant design for ensuring stability. Conclusions: Micro-CT analysis has proven to be a valuable tool for evaluating the intricate microstructural properties of dental implants, offering insights into implant stability, bone quality, and osseointegration. The literature reviewed highlights consistent findings that underscore micro-CT's accuracy and reliability in capturing high-resolution data, suggesting its potential as a standard imaging modality in implant research and clinical assessment. [ABSTRACT FROM AUTHOR]

Micro-computed tomography (micro-CT) is an invaluable tool for the evaluation of dental implant success, whereby the assessment of bone microstructure is conducted. This review examines the role of micro-CT in evaluating bone microstructure in dental implants. A review of the current literature reveals that micro-CT enables the accurate measurement of bone volume, trabecular morphology, and connectivity density, all of which play a crucial role in implant stability. The high-resolution three-dimensional visualization capabilities of micro-CT are also beneficial for the analysis of osseointegration and the evaluation of bone augmentation biomaterials. Despite the existence of challenges such as imaging artifacts and limitations in in vivo applications, advancements in sub-micron resolution and artificial intelligence integration offer promise for improving diagnostic capabilities. Micro-CT provides valuable insights into bone microarchitecture and osseointegration dynamics, which have the potential to enhance pre-operative planning and clinical outcomes in dental implantology. Future research should prioritize the standardization of micro-CT analysis protocols and the exploration of direct clinical applications of this technology. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study is to compare bone union and soft-tissue healing in titanium implants with sandblasted, large-grit, acid-etched surfaces (SLA group) and femtosecond laser-treated surfaces (FEMTO group) in a rabbit model. Methods: Implants were inserted into rabbit tibiae, and implant stability, soft-tissue healing, and microscopic analyses (micro-CT and biopsy) were conducted. All animals maintained normal weight and health post-surgery. Results: Hemostasis was achieved at the laser incision site on the surgery day, but healing was slower compared to conventional methods. Micro-CT showed no significant differences in new bone formation or inflammatory tissue infiltration between groups. Tissue biopsy revealed slightly higher bone-implant contact in the FEMTO group compared to the SLA group, though not statistically significant. Conclusion: These findings suggest that femtosecond laser surface treatment may provide bone union comparable to or better than SLA treatment, though laser-assisted soft-tissue incisions heal more slowly. [ABSTRACT FROM AUTHOR]

This study investigates the effects of various surface modification techniques on the Ti-6Al-4V alloy for biomedical applications. Mechanical treatments (sandblasting, shot peening) and electrochemical corrosion using different electrolytes were employed to modify surface characteristics. Surface morphology, roughness, hardness, and chemical composition were analyzed using SEM, profilometry, and Raman spectroscopy. Cell attachment studies revealed that combined treatments, particularly shot peening followed by HF/HNO3 etching, significantly enhanced cell adhesion and distribution. The results demonstrate the potential for tailoring Ti-6Al-4V surfaces to optimize biocompatibility and osseointegration properties for dental and orthopedic implants. [ABSTRACT FROM AUTHOR]

PURPOSE. This pilot study investigated the effect of surface roughness on osseointegration by comparing two types of commercial SLA-treated dental implants with different surface roughness levels: moderately rough (Sa = 1 - 2 µm) and rough surfaces (Sa > 2 µm). MATERIALS AND METHODS. Two implant groups were studied: TS (rough surface) and ADD (moderately rough surface) groups. Surface characteristics were analyzed using optical profilometry and SEM. In vitro studies using BRITER cells assessed cell adhesion, proliferation, and osteogenic differentiation through CCK-8 assay and qRT-PCR for osteopontin (OPN), osteocalcin (OCN), and alkaline phosphatase (ALP) expression. The in vivo study involved 12 implants (six per group) placed in mandibular defects of two beagle dogs. After 8 weeks, histomorphometric analysis evaluated bone to implant contact (BIC) and inter-thread bone density (ITBD). Statistical analysis used Student's t-test and two-way ANOVA for in vitro data, and Mann-Whitney U test for in vivo data. RESULTS. Surface analysis revealed Sa values of 2.50 ± 0.27 µm for the TS group and 1.80 ± 0.06 µm for the ADD group. In vitro studies showed no significant differences in cell adhesion and proliferation between the groups (P > .05). However, gene expression patterns differed, with ADD group showing higher OPN expression (P < .001) and TS group showing higher ALP expression (P < .01). The in vivo study revealed no statistically significant differences in BIC and ITBD between the two groups (P > .05). CONCLUSION. Surface roughness influenced osteoblast differentiation in vitro, but did not significantly affect osseointegration outcomes in vivo. Both moderately rough and rough surfaces appeared to support comparable levels of osseointegration. Larger studies are needed to confirm these findings and determine optimal implant surface characteristics. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In the world of dental implants, the essential determinant of success lies in the phenomenon of osseointegration, wherein titanium implants exhibit the ability for robust integration with the surrounding bone and tissue. Beyond the inherent qualities of titanium which make it an attractive candidate as an implant material, attention has shifted towards its' tailored surface modifications. These methods help the implant manufacturers to modify the implant surface for successful osseointegration and higher chances of enduring implantation. This review explores different surface modification methods and their impact on the dental implant success. [ABSTRACT FROM AUTHOR]

The work deals with the technology of microplasma spraying of biocompatible coatings from Zr--Nb alloy and their properties. On the surface of a porous Zr--Nb coating with the most developed surface microrelief, the presence of both open macropores of up to 300 µm in size and micropores of up to 10 µm in size was revealed. The X-ray phase analysis of the formed Zr--Nb coatings showed the presence of phases of a-solid solution of Zr, oxide (ZrO2), nitride (ZrN) and carbide (ZrNbC2). The corrosion resistance of a microplasma Zr--Nb coating and Ti6Al4V alloy in a solution of 0.9 % NaCl, which simulates the environment of the human body, was determined. It is assumed that Zr-Nb alloy coatings produced by microplasma spraying on the surfaces of existing Ti6Al4V alloy endoprostheses will allow for the future improvement in corrosion resistance and osseointegration between the bone and the implant. [ABSTRACT FROM AUTHOR]

Abstract Background The advent of 3D-printing technology, which is capable of on-demand fabrication, has ushered in a new era for fixed implant prosthodontics. Over the past decade, immediately loaded 3D-printed titanium implants have demonstrated predictable clinical outcomes in human jaws, highlighting their superior osseointegration strength, which is attributed to their increased surface roughness. However, the biomechanical mechanisms underlying this enhanced osseointegration strength remain elusive, thereby impeding the standardization and broader clinical application of 3D-printed titanium implants. Methods Experimental 3D-printed titanium implants were fabricated via selective laser melting (SLM), and conventional sandblasted and acid-etched titanium implants (CNC-SLA) served as the control group. Implant surfaces were characterized with scanning electron microscopy, surface profilometry, energy-dispersive X-ray spectroscopy, and a contact angle meter. Implants (n = 10) were surgically inserted into the femoral condyle of New Zealand rabbits. At weeks 1, 2, and 8, micro-CT and undecalcified histological sections were used to assess histological osseointegration (n = 6), whereas removal torque analysis was performed to evaluate osseointegration strength (n = 4). At week 8, microscale finite element analysis of different bone-implant interfaces was conducted to predict the peri-implant bone strain under multidirectional implant loading. Results The surface roughness of the SLM implants was significantly greater than that of the CNC-SLA implants. Histological osseointegration assessments revealed equal levels of SLM and CNC-SLA implants at weeks 1, 2, and 8. Notably, after week 2, bone interlocking phenomenon appeared on the SLM implants. The removal torque for the SLM implants at week 2 were significantly greater (P

Introduction: After posterior lumbar interbody fusion (PLIF), trabecular bone remodeling (TBR) occurs in the vertebral body. This study aimed to investigate whether imaging findings obtained with PLIF are applicable to lateral lumbar interbody fusion (LLIF). Methods: A total of 53 cases who underwent one- or two-level LLIF with polyether ether ketone cage and posterior spinal fixation/fusion (PSF) were retrospectively included in this study. TBR, vertebral endplate cyst (VEC), facet union, and pseudarthrosis were investigated on computed tomography (CT) images at 3 months, 1 year, and 2 years postoperatively. Of the 53 patients, 36 (68%) who underwent CT examination at approximately 5 years postoperatively were subanalyzed. Results: TBR was commonly observed anterior to the cage on CT sagittal images. The TBR-positive rate was 21%, 67%, and 73% at 3 months, 1 year, and 2 years postoperatively, respectively. The 3-month TBR-positive segments showed significantly less VEC (0% vs. 29%, P=0.029) at 1 year postoperatively. The 1-year TBR-positive segments showed a significantly higher facet union rate (83% vs. 57%, P=0.019) and less pseudoarthrosis (0% vs. 13%, P=0.041) at 2 years postoperatively. At 5 years postoperatively, 50% of the 2-year TBR-positive segments turned negative with solid intervertebral bony fusion. Conclusions: TBR-positive segments had significantly lower future VEC positivity, higher future facet union rates, and lower future pseudarthrosis rates. In LLIF-PSF, TBR suggests the establishment of intervertebral stability and allows consideration of intervertebral biomechanics.

Abstract Phytonanoparticles have emerged as a promising class of biomaterials for enhancing bone regeneration and osseointegration, offering unique advantages in biocompatibility, multifunctionality, and sustainability. This comprehensive review explores the synthesis, characterization, and applications of phytonanoparticles in bone tissue engineering. The green synthesis approach, utilizing plant extracts as reducing and stabilizing agents, yields nanoparticles with intrinsic bioactive properties that can synergistically promote osteogenesis. We examine the mechanisms by which phytonanoparticles, particularly those derived from gold, silver, and zinc oxide, influence key molecular pathways in osteogenesis, including RUNX2 and Osterix signaling. The review discusses advanced strategies in phyto-nanoparticle design, such as surface functionalization and stimuli-responsive release mechanisms, which enhance their efficacy in bone regeneration applications. Preclinical studies demonstrating improved osteoblast proliferation, differentiation, and mineralization are critically analyzed, along with emerging clinical data. Despite promising results, scalability, standardization, and regulatory approval challenges persist. The review also addresses the economic and environmental implications of phyto-nanoparticle production. Looking ahead, we identify key research directions, including developing personalized therapies, combination approaches with stem cells or gene delivery, and long-term safety assessments. By harnessing the power of plant-derived nanomaterials, phytonanoparticles represent an innovative approach to addressing the complex challenges of bone regeneration, with potential applications spanning dental, orthopedic, and maxillofacial surgery. Graphical abstract

ABSTRACT Objective The clinical management of partial bone defects in lower limbs, particularly those resulting from osteomyelitis, remains a significant challenge. This study aimed to systematically evaluate the effectiveness of 3D‐printed porous Ti6Al4V prostheses in addressing osteomyelitis‐induced partial bone defects. Methods We established a comprehensive protocol for utilizing 3D‐printed prostheses for bone defect repair, encompassing 3D simulation of prosthesis implantation and internal fixation, finite element analysis (FEA), and clinical implementation. Mimics software facilitated simulation of fixation patterns and screw lengths. FEA modeled bone defects in the distal metaphyseal femur and distal diaphyseal tibia to assess changes in stress conduction pre‐ and post‐prosthesis implantation. The clinical study involved eight patients (average age: 56.3 years) with an average defect length of 14.9 cm. Postoperative outcomes were evaluated using X‐rays and the Lower Extremity Functional Scale (LEFS). Results FEA demonstrated that the implanted prostheses effectively shared stress and reduced the load on residual bone in both models, thus lowering the risk of fractures under external forces. The average follow‐up period was 24.5 months, with patients initiating weight‐bearing activities on average 7.8 days post‐surgery. Serial postoperative X‐rays demonstrated long‐term stability of the prostheses, with progressive bone regeneration around and integration with the prostheses. While two patients experienced infection recurrence requiring prosthesis removal and debridement, the remaining six showed significant improvement in LEFS scores, increasing from 31.5 preoperatively to 61.0 at the last follow‐up. Conclusions 3D‐printed porous Ti6Al4V prostheses effectively restore anatomical integrity and optimize stress conduction in lower limbs, resulting in substantial functional recovery. This innovative approach shows promise for wider clinical adoption and warrants further investigation in medical practice.

Failure of intraosseous prostheses is primarily attributed to implant loosening and infections. Current primary therapeutic modalities, such as antibiotics and local debridement, not only face challenges in thoroughly eliminating obstinate adhered bacteria but also encounter difficulties in ameliorating undue inflammatory reactions and regenerating impaired peri-implant bone tissues. Polyetheretherketone (PEEK) has excellent mechanical and physicochemical characteristics and has been used extensively as a medical biomaterial. However, the limited bactericidal and osseointegrative activities of bioinert PEEK restrict its clinical application. Herein, a microenvironment responsive coating with immobilised immunomodulatory magnesium ions (Mg2+) and disinfectant cerium oxide nanoparticles (CNPs) is designed via ion coordination mediated by polydopamine (PDA) and electrospinning based on collagen structure-bionic silk fibroin (SF). By utilising the pH responsiveness of SF, CNPs exhibit potent antibacterial effects in an acidic environment (pH 5.0) caused by local bacterial infection. Due to the chelation interaction with PDA and the constraint of SF, Mg2+ is slowly released, ameliorating the local immune microenvironment and boosting osteogenesis by upregulating M2 phenotype macrophages. Bioinformatics analysis indicates that the inflammation is suppressed via the NF-κB signaling pathway. Overall, this SF-based coating maximizes the synergistic effect of CNPs and Mg2+, offering enhanced antibacterial and osteoimmunomodulatory bioactivity for successful implantation.