Desulfovibrio fairfieldensis adhesion on implantable titanium used in odontology: a preliminary study.

The study presented here aimed to assess the ability of Desulfovibrio fairfieldensis bacteria to adhere to and form biofilm on the structure of titanium used in implants. D. fairfieldensis was found in the periodontal pockets in the oral environment, indicating that these bacteria can colonize the implant-bone interface and consequently cause bone infection and implant corrosion. Plates of implantable titanium, of which surfaces were characterized by scanning electronic microscopy and Raman spectroscopy, were immersed in several suspensions of D. fairfieldensis cells containing potassium nitrate on the one hand, and artificial saliva or a sulfato-reducing bacterial culture medium on the other hand. Following various incubation timepoints bacteria were counted in different media to determine their doubling time and titanium samples are checked for and determination of the total number of adhered bacteria and biofilm formation. Adhesion of D. fairfieldensis on titanium occurs at rates ranging from 2.105 to 4.6.106 bacteria h-1cm-2 in the first 18 h of incubation on both native and implantable titanium samples. Following that time, the increase in cell numbers per h and cm2 is attributed to growth in adhered bacteria. After 30 days of incubation in a nutrient-rich medium, dense biofilms are observed forming on the implant surface where bacteria became embedded in a layer of polymers D. fairfieldensis is able of adhering to an implantable titanium surface in order to form a biofilm. Further studies are still necessary, however, to assess whether this adhesion still occurs in an environment containing saliva or serum proteins that may alter the implant surface.

Innovative Bioactive Ca-SZ Coating on Titanium Dental Implants: A Multidimensional Structural and Elemental Analysis.

The design of new, biomimetic biomaterials is of great strategic interest and is converging for many applications, including in implantology. This study explores a novel approach to improving dental implants. Although endosseous TA6V alloy dental implants are widely used in oral implantology, this material presents significant challenges, notably the prevalence of peri-implantitis. Therefore, in this study, we investigate a new advance in the design of hybrid medical devices. This involves the design of a Ca-SZ coating deposited by PVD on a TA6V substrate. This approach aims to overcome the inherent limitations of each of these materials, namely TA6V's susceptibility to peri-implantitis on the one hand and zirconia's excessively high Young's modulus compared with bone on the other, while benefiting from their respective advantages, such as the ductility of TA6V and the excellent biocompatibility of zirconia, offering relevant prospects for the design of high-performance implantable medical devices. This study integrates characterisation techniques, focusing on the structural and elemental analysis of the Ca-SZ coating by XRD and TEM. The results suggest that this coating combines a tetragonal structure, a uniform morphology with no apparent defects, a clean interface highlighting good adhesion, and a homogeneous composition of calcium, predisposing it to optimal biocompatibility. All of these findings make this innovative coating a particularly suitable candidate for application in dental implantology.

Zirconia Dental Implants: A Closer Look at Surface Condition and Intrinsic Composition by SEM-EDX.

Modern dental implantology is based on a set of more or less related first-order parameters, such as the implant surface and the intrinsic composition of the material. For decades, implant manufacturers have focused on the research and development of the ideal material combined with an optimal surface finish to ensure the success and durability of their product. However, brands do not always communicate transparently about the nature of the products they market. Thus, this study aims to compare the surface finishes and intrinsic composition of three zirconia implants from three major brands. To do so, cross-sections of the apical part of the implants to be analyzed were made with a micro-cutting machine. Samples of each implant of a 4 to 6 mm thickness were obtained. Each was analyzed by a tactile profilometer and scanning electron microscope (SEM). Compositional measurements were performed by X-ray energy-dispersive spectroscopy (EDS). The findings revealed a significant use of aluminum as a chemical substitute by manufacturers. In addition, some manufacturers do not mention the presence of this element in their implants. However, by addressing these issues and striving to improve transparency and safety standards, manufacturers have the opportunity to provide even more reliable products to patients.

The Surface Conditions and Composition of Titanium Alloys in Implantology: A Comparative Study of Dental Implants of Different Brands.

The success of titanium dental implants depends on their osseointegration into the bone, which is determined by the composition and surface properties of the implant in close contact with the bone. There is a wide variety of implants on the market. Is it possible to identify the implant with the best composition and surface topography for optimal osseointegration? To this aim, 13 brands of dental implants from nine distinct manufacturers have been selected and their composition and surface topography determined. The obtained results show differences between these implants, in this case, the Ssk averages of the three measurements performed on each implant were positive, or 0.4 (0.1-0.8), indicating that the roughness of all implants analyzed was primarily textured and not flat. Like Sa, we found the highest Sdr for implants subjected only to sandblasting. In addition, only the ALS-active® implant had a modified microstructure on its surface. However, analysis of the NANOTITE implant surface revealed a 1.40% presence of calcium which we consider too low to have an effect on bone formation around the implant. As a result, we have also highlighted the lack of a recognized independent standard for dental implant surface conditions and the lack of independent quality control vis-à-vis manufacturers. Of all the surface types studied, none proved more satisfactory than another.

Biocompatibility of ZrO2 vs. Y-TZP Alloys: Influence of Their Composition and Surface Topography.

The osseointegration of implants is defined as the direct anatomical and functional connection between neoformed living bone and the surface of a supporting implant. The biological compatibility of implants depends on various parameters, such as the nature of the material, chemical composition, surface topography, chemistry and loading, surface treatment, and physical and mechanical properties. In this context, the objective of this study is to evaluate the biocompatibility of rough (Ra = 1 µm) and smooth (Ra = 0 µm) surface conditions of yttria-zirconia (Y-TZP) discs compared to pure zirconia (ZrO2) discs by combining a classical toxicological test, morphological observations by SEM, and a transcriptomic analysis on an in vitro model of human Saos-2 bone cells. Similar cell proliferation rates were observed between ZrO2 and Y-TZP discs and control cells, regardless of the surface topography, at up to 96 h of exposure. Dense cell matting was similarly observed on the surfaces of both materials. Interestingly, only 110 transcripts were differentially expressed across the human transcriptome, consistent with the excellent biocompatibility of Y-TZP reported in the literature. These deregulated transcripts are mainly involved in two pathways, the first being related to "mineral uptake" and the second being the "immune response". These observations suggest that Y-TZP is an interesting candidate for application in implantology.

In Vitro Molecular Study of Titanium-Niobium Alloy Biocompatibility.

Titanium dental implants have common clinical applications due to their biocompatibility, biophysical and biochemical characteristics. Although current titanium is thought to be safe and beneficial for patients, there are several indications that it may release toxic metal ions or metal nanoparticles from its alloys into the surrounding environment, which could lead to clinically relevant complications including toxic reactions as well as immune dysfunctions. Hence, an adequate selection and testing of medical biomaterial with outstanding properties are warranted. This study was designed to explore the biocompatibility of smooth titanium-niobium alloy (S_TiNb) versus smooth titanium commercially pure (S_TiCp)-a reference in implantology. All experiments were performed in vitro using human osteoblast-like SaOs-2 and monocyte THP-1 cell lines as models. Cell adhesion and growth morphology were determined by scanning electron microscopy, while cell viability was evaluated using WST-1 assay. Because niobate anions or niobium nanoparticles can be released from implants during biomaterial-cell interaction, potential immunotoxicity of potassium niobate (KNbO3) salt was evaluated by examining both metabolic activity and transcriptomic profiling of treated THP-1 monocytes. The main findings of this study are that S_TiCp and S_TiNb discs do not show an impact on the proliferation and viability of SaOs-2 cells compared to polystyrene surfaces, whereas a significant decrease in THP-1 cells' viability and metabolic activity was observed in the presence of S_TiNb discs compared to the control group. However, no significant changes were found neither at the metabolic activity nor at the transcriptomic level of THP-1 monocytes exposed to KNbO3 salt, suggesting that niobium has no effect on the immune system. Overall, these data imply a possible toxicity of S_TiNb discs toward THP-1 cells, which may not be directly related to niobium but perhaps to the manufacturing process of titanium-niobium alloy. Thus, this limitation must be overcome to make titanium alloy an excellent material for medical applications.

Feasibility of treating irradiated bone with intramedullary delivered autologous mesenchymal stem cells.

BACKGROUND: We aimed to explore (i) the short-term retention of intramedullary implanted mesenchymal stem cells BMSCs and (ii) their impact on the bone blood flow and metabolism in a rat model of hindlimb irradiation. METHODS: Three months after 30 Gy irradiation, fourteen animals were referred into 2 groups: a sham-operated group (n = 6) and a treated group (n = 8) in which ¹¹¹In-labelled BMSCs (2 × 106 cells) were injected in irradiated tibias. Bone blood flow and metabolism were assessed by serial (99m)Tc-HDP scintigraphy and 1-wk cell retention by recordings of (99m)Tc/¹¹¹In activities. RESULTS: The amount of intramedullary implanted BMSCs was of 70% at 2 H, 40% at 48 H, and 38% at 168 H. Bone blood flow and bone metabolism were significantly increased during the first week after cell transplantation, but these effects were found to reduce at 2-mo followup. Conclusion. Short-term cell retention produced concomitant enhancement in irradiated bone blood flow and metabolism.

Functional fixation of autotransplanted tooth germs by using bioresorbable membranes.

OBJECTIVE: The purpose of this study was to evaluate the contribution of a bioresorbable membrane placement to the healing of immature teeth after autotransplantation of tooth buds. STUDY DESIGN: Six cases were selected: 2 transplantations of wisdom teeth, 2 for premolar agenesis, 1 for ectopia, and 1 premolar in an incisor position. The crown of each tooth germ and the marginal alveolar bone were covered with a resorbable membrane. RESULTS: The radicular edification was nearly complete, neither ankylosis nor inflammatory resorption was observable, the pulp vitality was preserved, and the periodontal integration was identical to that of other teeth. The membrane ensured contention and stabilization of the transplant, allowed functional stimulation, permitted protection of the coagulum and periodontal cells, and kept the epithelium at a distance. CONCLUSIONS: The transplantations of immature teeth were improved by the use of a resorbable membrane, which caused an optimal functional fixation of the transplanted tooth.

Relative contribution of haptic technology to assessment and training in implantology.

BACKGROUND: The teaching of implant surgery, as in other medical disciplines, is currently undergoing a particular evolution. AIM OF THE STUDY: To assess the usefulness of haptic device, a simulator for learning and training to accomplish basic acts in implant surgery. MATERIALS AND METHODS: A total of 60 people including 40 third-year dental students without knowledge in implantology (divided into 2 groups: 20 beginners and 20 experiencing a simulator training course) and 20 experienced practitioners (experience in implantology >15 implants) participated in this study. A basic exercise drill was proposed to the three groups to assess their gestural abilities. RESULTS: The results of the group training with the simulator tended to be significantly close to those of the experienced operators. CONCLUSION: Haptic simulator brings a real benefit in training for implant surgery. Long-term benefit and more complex exercises should be evaluated.

Experimental model of naturally occurring post-radiation sarcoma: interest of positron emission tomography (PET) for early detection.

Radiotherapy is an integral part of overall cancer therapy. One of the most serious adverse effects of irradiation concern, for long-term survivors, the development of post-radiation sarcoma (PRS) in healthy tissues located within the irradiated area. PRS have bad prognosis and are often detected at a late stage. Therefore, it is obvious that the early detection PRS is a key-point and the development of preclinical models is worthy to evaluate innovative diagnostic and therapeutic procedures. The aim of this study was to develop a spontaneous rodent model of PRS and to evaluate the potency of Positron Emission Tomography (PET) for early detection. Fifteen Wistars rats were irradiated unilateraly on the hindlimb with a single dose of 30 Gy. Sequential analysis was based on observational staging recordings, Computerized Tomography (CT) scanning and PET. Tumors were removed and, histopathological and immunochemistry analyses were performed. Among the irradiated rats, 12 sarcomas (80%) were detected. All tumors occurred naturallty within the irradiated hindlimb and were highly aggressive since most tumors (75%) were successfully transplanted and maintained by serial transplantation into nude mice. Upon serial staging recordings, using PET, was found to enable the detection of PRS earlier after irradiation than with the other methods (i.e. 11.9 ± 1.8 vs 12.9 ± 2.6 months). These results confirmed the interest of experimental models of PRS for the preclinical evaluation of innovative diagnostic strategies and confirmed the potency of PET for early detection of PRS. This preclinical model of PRS can also be proposed for the evaluation of therapeutic strategies.

Long-term alterations of cytokines and growth factors expression in irradiated tissues and relation with histological severity scoring.

PURPOSE: Beside its efficacy in cancer treatment, radiotherapy induces degeneration of healthy tissues within the irradiated area. The aim of this study was to analyze the variations of proinflammatory (IL-1α, IL-2, IL-6, TNF-α, IFN-γ), profibrotic (TGF-ß1), proangiogneic (VEGF) and stem cell mobilizing (GM-CSF) cytokines and growth factors in an animal model of radiation-induced tissue degeneration. MATERIALS AND METHODS: 24 rats were irradiated unilaterally on the hindlimb at a monodose of 30 Gy. Six weeks (n=8), 6 months (n=8) and 1 year (n=8) after irradiation the mediators expression in skin and muscle were analyzed using Western blot and the Bio-Plex® protein array (BPA) technology. Additional histological severity for fibrosis, inflammation, vascularity and cellularity alterations scoring was defined from histology and immnunohistochemistry analyses. RESULTS: A significant increase of histological severity scoring was found in irradiated tissue. Skin tissues were more radio-sensitive than muscle. A high level of TGF-ß1 expression was found throughout the study and a significant relation was evidenced between TGF-ß1 expression and fibrosis scoring. Irradiated tissue showed a chronic inflammation (IL-2 and TNF-α significantly increased). Moreover a persistent expression of GM-CSF and VEGF was found in all irradiated tissues. The vascular score was related to TGF-ß1 expression and the cellular alterations score was significantly related with the level of IL-2, VEGF and GM-CSF. CONCLUSION: The results achieved in the present study underline the complexity and multiplicity of radio-induced alterations of cytokine network. It offers many perspectives of development, for the comprehension of the mechanisms of late injuries or for the histological and molecular evaluation of the mode of action and the efficacy of rehabilitation techniques.

Re-assessment of chronic radio-induced tissue damage in a rat hindlimb model.

Radiotherapy is successfully used to treat neoplastic lesions, but may adversely affect normal tissues within the irradiated volume. However, additional clinical and para-clinical data are required for a comprehensive understanding of the pathogenesis of this damage. We assessed a rat model using clinical records and medical imaging to gain a better understanding of irradiation-induced tissue damage. The hindlimbs of the rats in this model were irradiated with a single dose of 30 or 50 Gy. Sequential analysis was based on observation records of stage and planar scintigraphy. Additional radiography, radiohistology and histology studies were performed to detect histological alterations. All animals developed acute and late effects, with an increased severity after a dose of 50 Gy. The bone uptake of (99m)Tc-HDP was significantly decreased in a dose- and time-dependent manner. Histologically, significant tissue damage was observed. After the 50 Gy irradiation, the animals developed lesions characteristic of osteoradionecrosis (ORN). Radiographic and histological studies provided evidence of lytic bone lesions. Our rat model developed tissue damage characteristic of radiation injury after a single 30 Gy irradiation and tissue degeneration similar to that which occurs during human ORN after a 50 Gy irradiation. The development of this animal model is an essential step in exploring the pathogenesis of irradiation-induced tissue damage, and may be used to test the efficacy of new treatments.

Rehabilitation of irradiated head and neck tissues by autologous fat transplantation.

BACKGROUND: Treatment of head and neck cancers allows good carcinologic results but induces aesthetic and functional sequelae. Autologous fat transplants have been used to correct aesthetic defects since the past century and exhibit many of the qualities of the ideal filler. Results reported here stem from experiences from 2000, with abdominal fat grafting in 11 patients who were referred to the authors' center for aesthetic subcutaneous or submucous head and neck reconstruction after radiotherapy. METHODS: Abdominal fat tissues were harvested, and injection into host sites was performed in a manner similar to that of the lipostructure technique described by Coleman. The postoperative follow-up periods ranged from 2 to 88 months (mean, 39.9 months). Clinical monitoring of the patients was carried out. Additional pathologic study was performed on irradiated tissues surrounding the scar and on abdominal fat and treated tissues. RESULTS: No surgical procedure complications occurred. For all cases, except for one patient, the rehabilitation was aesthetic and functional. The quality of life of the patients was improved. The pathologic data highlighted a decrease in irradiated morphologic patterns characterized by an absence of necrotic areas and a high vascular network density associated with a normal histologic structure. CONCLUSIONS: Fat tissues can be successfully transplanted into irradiated areas, inducing both aesthetic and functional improvement. The cellular and/or tissular mechanisms underlying these changes need further investigation.

Lingual vascular canals of the mandible: the risk of bleeding complications during implant procedures.

PURPOSE: The aim of this article is to investigate the potential risk of a critical life-threatening hemorrhage due to the perforation of the lingual cortical plate and arterial trauma of the terminal branches of the sublingual artery. In fact, in many cases, implants are placed in the mandibular interforaminal region, and this area is also often involved in oral surgery as a bone donor site. MATERIALS AND METHODS: One hundred dry skull Caucasian mandibles and 100 computed tomographies (CTs) of the mandible of Caucasian patients were examined. The entrances of the lingual vascular canals were analyzed. Positions and dimensions of the entrances are reported. RESULTS: In 80% of the dry skull mandibles, at least 1 lingual canal was found, and the CT scan detected the presence of at least 1 lingual vascular canal in up to 60% of patients. CONCLUSIONS: A CT examination should routinely be performed before any surgical approach to the interforaminal region.