Biomolecule-functionalized dental implant surfaces: Towards augmenting soft tissue integration.

Soft tissue integration (STI) at the transmucosal level around dental implants is crucial for the long-term success of dental implants. Surface modification of titanium dental implants could be an effective way to enhance peri-implant STI. The present study aimed to investigate the effect of bioinspired lithium (Li)-doped Ti surface on the behaviour of human gingival fibroblasts (HGFs) and oral biofilm in vitro. HGFs were cultured on various Ti surfaces—Li-doped Ti (Li_Ti), NaOH_Ti and micro-rough Ti (Control_Ti)—and were evaluated for viability, adhesion, extracellular matrix protein expression and cytokine secretion. Furthermore, single species bacteria (Staphylococcus aureus) and multi-species oral biofilms from saliva were cultured on each surface and assessed for viability and metabolic activity. The results show that both Li_Ti and NaOH_Ti significantly increased the proliferation of HGFs compared to the control. Fibroblast growth factor-2 (FGF-2) mRNA levels were significantly increased on Li_Ti and NaOH_Ti at day 7. Moreover, Li_Ti upregulated COL-I and fibronectin gene expression compared to the NaOH_Ti. A significant decrease in bacterial metabolic activity was detected for both the Li_Ti and NaOH_Ti surfaces. Together, these results suggest that bioinspired Li-doped Ti promotes HGF bioactivity while suppressing bacterial adhesion and growth. This is of clinical importance regarding STI improvement during the maintenance phase of the dental implant treatment.

The effect of microstructured surfaces and laminin-derived peptide coatings on soft tissue interactions with titanium dental implants

Dental implants have totally transformed restorative dentistry, as this has made tooth loss and edentulism treatable with greater consistency and longevity. Therefore, the efficacy of dental implants is inextricably related to the inherent characteristics of the biomaterials used, which is paramount in promoting osseointegration and ensuring satisfactory function and aesthetics. Through the years, growth in materials science has driven changes in biomaterials toward dental implants, from some simple materials to complex substances manifesting improved biocompatibility, mechanical strength, and chemical resistance. This review will elaborate on the progress of innovation in dental implant biomaterials, discussing commonly used materials like titanium, ceramics, and new innovations including nanostructured surfaces, bioactive coatings, and 3D-printed biomaterials. These materials are focused to be used in improving integration of soft and hard tissue, preventing complications such as peri-implantitis, and promoting bone regeneration. Challenges such as biodegradability, manufacturing complexity, and cost are then discussed along with strategies of overcoming these challenges. It emphasizes future directions that include intelligent biomaterials, artificial intelligence-guided design, and sustainable methodologies for developing biomaterials. The current applications and prospective opportunities are analyzed in this review to exemplify the revolutionary capacity of sophisticated biomaterials to augment the clinical effectiveness and the durability of dental implants.

Gallium-doped dual micro-nano titanium dental implants towards soft-tissue integration and bactericidal functions

Soft tissue seal around implant prostheses is considered the primary barrier against adverse external stimuli and is a critical factor in maintaining dental implants’ stability. Soft tissue seal is formed mainly by the adhesion of epithelial tissue and fibrous connective tissue to the transmembrane portion of the implant. Type 2 diabetes mellitus (T2DM) is one of the risk factors for peri-implant inflammation, and peri-implant disease may be triggered by dysfunction of the soft tissue barrier around dental implants. This is increasingly considered a promising target for disease treatment and management. However, many studies have demonstrated that pathogenic bacterial infestation, gingival immune inflammation, overactive matrix metalloproteinases (MMPs), impaired wound healing processes and excessive oxidative stress may trigger poor peri-implant soft tissue sealing, which may be more severe in the T2DM state. This article reviews the structure of peri-implant soft tissue seal, peri-implant disease and treatment, and moderating mechanisms of impaired soft tissue seal around implants due to T2DM to inform the development of treatment strategies for dental implants in patients with dental defects.

<p>Dentistry has come a long way from its humble beginnings. Like all other healthcare specialties, dentistry has evolved through the years. The understanding of physiology of dental health and disease has evolved allowing us to treat dental diseases much more efficiently. However not all dental problems are fully understood.</p><p>Diseases that affect the bone and soft tissue around teeth and dental implants, also known as “periodontal” and peri-implant” diseases respectively, have proven to be among the least understood and challenging dental diseases to treat. Recent advancements in microbiology and immunology have revealed that periodontal and peri implant disease have a plethora of interactions between the invading bacteria, the defensive human cells, and signaling micro molecules that control inflammation. Those interactions have opened up a new frontier for researchers in dentistry, microbiology, immunology, pharmacology and dental materials to understand these interactions and explore possible new treatments.</p><p>Simvastatin is a commonly prescribed drug used to control blood cholesterol. Recent research has revealed that simvastatin also possesses potent anti-inflammatory properties, and research has shown that topical application simvastatin is effective at controlling inflammation around teeth with periodontitis. However it has not yet been tested around dental implants with peri-implant disease. Thus the purpose of the current study is to investigate the effect of topical simvastatin on implants with peri-implant inflammation</p>

Single-cell analysis of peri-implant gingival tissue to assess implant biocompatibility and immune response

Dental implants have become the preferred solution for tooth replacement, offering both functional and aesthetic benefits that closely mimic natural teeth. This research investigates advancements in dental implant technology, including material innovations, surface treatments, and osseointegration techniques, which contribute to improved patient outcomes. We conducted a systematic review of material selection, design, and stress analysis and fatigue life for better treatment. Additionally, this study explores the role of biocompatible materials, such as titanium, zirconia alloys and ceramic composites, in enhancing implant durability and integration. The impact of digital dentistry tools, including computer-aided design and manufacturing (CAD/CAM) for custom implants, was analysed to determine their effect on surgical precision and recovery times. Results indicate that enhanced surface treatments and optimized implant geometries significantly increase stability and longevity, reducing complications associated with traditional implants. These findings highlight the importance of interdisciplinary advancements in improving the reliability of dental implants and suggest future directions for further refinement.

Chemical and topographical surface modifications on dental implants aim to increase the bone surface contact area of the implant and improve osseointegration. This study analyzed the cellular response of undifferentiated mesenchymal stem cells (MSC), derived from senile rats’ femoral bone marrow, when cultured on a bioactive coating (by plasma electrolytic oxidation, PEO, with Ca2+ and P5+ ions), a sandblasting followed by acid-etching (SLA) surface, and a machined surface (MSU). A total of 102 Ti-6Al-4V discs were divided into three groups (n = 34). The surface chemistry was analyzed by energy dispersive spectroscopy (EDS). Cell viability assay, gene expression of osteoblastic markers, and mineralized matrix formation were investigated. The cell growth and viability results were higher for PEO vs. MSU surface (p = 0.001). An increase in cell proliferation from 3 to 7 days (p < 0.05) and from 7 to 10 days (p < 0.05) was noted for PEO and SLA surfaces. Gene expression for OSX, ALP, BSP, and OPN showed a statistical significance (p = 0.001) among groups. In addition, the PEO surface showed a higher mineralized matrix bone formation (p = 0.003). In conclusion, MSC from senile female rats cultured on SLA and PEO surfaces showed similar cellular responses and should be considered for future clinical investigations.

Several measurements are combined to diagnose peri-implant disease, and different thresholds are used to describe the disease. The purpose of this study was to evaluate the prevalence of peri-implant disease and to apply different diagnostic thresholds to assess its prevalence in relation to severities of peri-implantitis with different degrees of bone loss. A total of 164 subjects with dental implants inserted at the Institute of Clinical Odontology, University of Oslo, between 1990 and 2005, were invited to join the project, and 109 subjects attended the examination (mean age: 43.8 years; range: 18 to 80 years). The mean functional loading time was 8.4 years (SD: 4.6 years). The participants were examined clinically and radiographically. The following aspects of disease were assessed to describe the peri-implant condition: detectable radiographic peri-implant bone loss and inflammation, the presence of bleeding on probing at a probing depth >or=4 or >or=6 mm, and radiographic peri-implant bone loss assessed at >or=2.0 and >or=3.0 mm. Assessing peri-implantitis at different levels of severity yielded a substantial variance in prevalence (11.3% to 47.1%) in the present study population. Peri-implant inflammation was a frequent finding with and without peri-implant bone loss.

Dental implants have been widely applied in partially and fully edentulous patients and have shown predictable clinical outcomes, but there are still many cases of implant failures, such as osseointegration failure and peri-implant inflammation. To improve the success rate of implants, especially in improving osseointegration and antibacterial performance, various methods of implant surface modification have been applied. Surface modification methods covered include sandblasting with large-grit corundum and acid etched (SLA), plasma spraying, plasma immersion ion implantation (PIII), sputter-deposition, selective laser melting (SLM), anodic oxidation, microarc oxidation, sol-gel coating, alkaline heat treatment (AH) and Layer-by-Layer (LBL) self-assembly. This review comprehensively summarizes the influence of each method on osseointegration and biofilm attachment. The mechanical, chemical and biological disadvantages of these methods are involved. Besides, the mechanisms behind such techniques as increasing surface roughness to expand superficial area and enhance the adhesion of osteoblastic cells are discussed.

The symmetry of masticatory muscle tension in tooth loss undergoes various changes due to the reorganization of the chewing process itself. Electromyography (EMG) of the masticatory muscle’s measures muscle tone over time, for example, during the chewing cycle or during clenching. Thus, EMG can provide an assessment of muscle tone during the chewing sequence. Since bite force and chewing efficiency are important parameters, the use of EMG in patients with tooth loss can be an effective tool for diagnosing various pathological processes. Purpose: to identify a correlation between the restoration of chewing function in patients with tooth loss and the symmetry of masticatory and temporal muscle tension. Materials and methods. 20 patients with tooth loss (K08.1) underwent dental implant placement in the upper and lower jaws followed by prosthetic rehabilitation. Before surgery and one month after permanent prosthetic rehabilitation, electromyography (EMG) was used to measure the activity of the masseter and temporal muscles (total amplitude during teeth clenching) and calculate the symmetry index of muscle tension on the right and left sides. Results. Preoperative measurements showed average muscle tension levels of 27.00±9.78 mV in the right temporal muscle and 28.15±9.60 mV in the left temporal muscle. For masseter muscles, the total clenching amplitude was 24.30±5.56 mV on the left side and 20.60±8.88 mV on the right. After one month of prosthetic rehabilitation, significant correlations emerged between masticatory function recovery and muscle activity patterns: analysis revealed an inverse ipsilateral relationship between masseter and temporal muscles (r=−0.87 right, r=−0.74 left, p&lt;0.001), bilateral synchronization of masseter muscles (r=0.72, p&lt;0.001), and cross-muscle regulatory patterns (Md/Ts: r=−0.45, p=0.046; Ms/Td: r=−0.63, p=0.003) demonstrating asymmetric masticatory control mechanisms, while demonstrating improved symmetry following prosthetic rehabilitation. Conclusion. Overall, this work shows that the activity of the masticatory muscles in patients with tooth loss improves after orthopedic rehabilitation on dental implants. This improvement is manifested in a more symmetrical tone of the masticatory muscles.

Worldwide, head and neck cancer (HNC–Head Neck Cancer) is one of the most common types of neoplasms with an ever-increasing prevalence and mortality rate. The aim of the work is to improve the methods of restoring masticatory function in patients who previously received radiation and chemotherapy, dental implantation techniques with immediate loading and the use of radio detectors based on sodium deoxyribonucleate ("Coletex-Gel-DNA-L"). Materials and methods. The main group included 61 patients. For local radiation treatment, the drugs "Coletex-gel-DNA" and "Coletex-gel-DNA-L" were used. The control group included 77 patients who, for the prevention and treatment of radiation reactions of the mucous membranes of the oral cavity, used the classical method — applications of stone oils (olive, sunflower). Results. Of the 79 dental implants installed in patients of the second group, 17 implants were removed due to perimplantitis. The implant survival rate is 78.5% in the control group. Based on a follow-up period of 12 ± 2 months, the survival rate of implants was calculated in patients of the main and control groups. when using the drugs "Coletex-gel-DNA" and "Coletex-gel-DNA-L", there was a decrease in the frequency of radiation reactions of the III degree from 66.8 to 24.6% compared with the classical method of prevention, I and II degrees of radioepithelitis prevail, the results are reliable (p &lt;0.01). IV degree was not observed in any patient of both groups. Conclusion. The results obtained indicate the effectiveness of the use of the drugs "Coletex-gel-DNA" and "Coletex-gel-DNA-L" for the prevention and treatment of radiation reactions of the oral mucosa and pharynx in patients with malignant neoplasms of the oropharyngeal zone. In this regard, this drug may be recommended for use as a therapy to accompany radiation, chemoradiotherapy and combined treatment. The introduction into the practice of dentists, the algorithm of complex restoration of masticatory function in patients with a history of oncology is justified. It is possible to reduce side effects, improve the recovery process.

Biomaterial bridges constructed from electrospun fibers offer a promising alternative to traditional nerve tissue regeneration substrates. Aligned and unaligned polycaprolactone (PCL) electrospun fibers were prepared and functionalized with the extracellular matrix proteins collagen and laminin using covalent and physical adsorption attachment chemistries. The effect of the protein modified and native PCL nanofiber scaffolds on cell proliferation, neurite outgrowth rate, and orientation was examined with neuronlike PC12 cells. All protein modified scaffolds showed enhanced cellular adhesion and neurite outgrowth compared to unmodified PCL scaffolds. Neurite orientation was found to be in near perfect alignment with the fiber axis for cells grown on aligned fibers, with difference angles of less than 7° from the fiber axis, regardless of the surface chemistry. The bioavailability of PCL fibers with covalently attached laminin was found to be identical to that of PCL fibers with physically adsorbed laminin, indicating that the covalent chemistry did not change the protein conformation into a less active form and the covalent attachment of protein is a suitable method for enhancing the biocompatibility of tissue engineering scaffolds.

IntroductionIntraosseous vascular malformations (IVM) of the jaw are rare in the adolescent. Skeleto-facial development of children is known, but facial asymmetry after hemimandibulectomy may occur in adolescence because of growth. A 12-year-old girl was performed anterior hemimandibulectomy with immediate mandibular reconstruction by fibula free flap (FFF) because of an IVM. We present an interdisciplinary treatment concept with orthodontic treatment, dental implantation, and customized high-density porous polyethylene chin augmentation on free musculocutaneous fibula reconstruction in an adolescent as a ten-year follow-up. AimThe presented case describes the complex interdisciplinary treatment of an adolescent suffering from the destruction of the anterior mandible caused by low-flow intraosseous venous malformation. The case report's task is to examine whether the use of customized chin implants on FFF can be a useful addition to a growth-adapted dentofacial restoration of faces in young adulthood. DiscussionFacial growth in adolescents after tumor resection and reconstruction seems to be unpredictable. The use of customized chin-implants in children is controversial. The anticipation of the presumed adult dimensions is necessary for the correct extension. For observation of facial development, lateral-views, and CBCT, are suitable. Orienting the reconstructed mandible to correctly adjusted maxilla by orthodontic advice and early loaded implants, the development of mandible deficits can be compensated, and an average face height ratio and a mesiofacial profile anticipated.Clinical relevance/Purpose: In line with other publications, this case shows that accompanying orthodontic treatment of the opposing maxilla after free fibula graft in the mandible is decisive for masticatory function. Immediate dental rehabilitation by fixed prosthetics on dental implants and insertion of HDPE-chin implants for facial harmonization during puberty demonstrates average growth and could be a possible concept to avoid secondary orthognathic interventions.The investigators hypothesized that mandibular growth-curves after sagittal hemimandibulectomy are mainly in the superior and posterior ramus (20%) compared to horizontal ramus (5%) mandibular angulation so that customized HDPE-chin reconstruction in adolescent should be progenic oversized to correct the horizontal deficit. The authors have reported a unique concept of orthodontic treatment, immediate loading of dental implants of the vascularized fibula, and customized chin-augmentation by evaluating angle, length, and facial profile by images of CBCT and lateral view 5 and 10 years after single step surgery.The skeleto-facial development of growing children after hemimandibulectomy is unpredictable. The presented case describes the complex interdisciplinary treatment of an adolescent suffering from the destruction of the anterior mandible caused by intraosseous venous malformation and consecutive hemimandibulectomy. A functional oral restoration with Fibula Free Flap (FFF), orthodontic treatment, immediate loading of dental implants, and fixed bridges a juvenile facial rehabilitation demand an age-appropriate treatment plan. The case report's task is to examine whether the use of customized chin implants can be a useful addition to a growth-adapted dentofacial restoration of faces in young adulthood.