Implants With and Without Laser-Microtextured Collar: A 10-Year Clinical and Radiographic Comparative Evaluation.

INTRODUCTION: This article reports, after at least 10 years of follow-up, the comparative data of marginal bone loss (MBL) and periimplant soft tissue parameters, around implant with and without laser-microtextured (L) collar surface, previously reported at 3 years of follow-up. MATERIALS AND METHODS: Twenty implants with L collar surface (test) were placed adjacent to 20 control implants with machined (M) collar surface in 15 partially edentulous patients, who were followed up for at least 10 years as part of a prospective longitudinal study. The plaque score, bleeding on probing (BoP) score, and probing depth (PD) were recorded at baseline and at each year follow-up examination. Mucosal recession (MR), and radiographic MBL were assessed at baseline and after at least 10 years. RESULTS: Four patients were lost during follow-up, so the number of implants that have been followed for at least 10 years was 32 (16 tests and 16 controls). At the end of the follow-up period, no significant differences were found between the study groups regarding the presence of plaque and BoP (P > 0.05). A statistically significant difference between test and control implant was found for mean PD (2.3 ± 0.7 mm vs 3.8 ± 0.8), MBL (1.23 ± 0.21 mm vs 2.8 ± 0.9 mm), and mean MR (1.08 ± 0.4 mm vs 2.46 ± 0.3 mm). CONCLUSION: Results suggest that after at least 10 years of function, implants with laser-microtexturing (L) collar surface, compared with implants with machined surface, lead to lower MBL and PD.

Compliance with a New York State 2010 HIV Testing Law: Is There Racial/Ethnic Bias in HIV Testing? Experience of Monroe County, New York, 2012.

BACKGROUND: While routine HIV testing in the general population is a national recommendation, actual practice may vary. PURPOSE: To determine risk factors associated with HIV testing after the adoption of a New York State law in 2010 mandating that health care providers offer HIV testing in all clinical settings. METHODS: Survey data from Monroe County, New York, were collected in 2012 for adults aged 18-64 years and analyzed in 2014. Logistic regression was used to identify risk factors independently associated with HIV testing and high-risk behavior. RESULTS: Among adults aged 18-34, fewer Whites were offered HIV testing in the past year by their doctors compared with Blacks (34% vs 64%) despite having similar rates of any HIV high-risk behavior (20% overall). For adults aged 35-64 years, fewer Whites than Blacks were ever tested for HIV (42% vs 71%), offered HIV testing in past year (17% vs 40%), and reported any HIV high-risk behavior (3% vs 13%). Latinos showed intermediate levels. With logistic regression analysis, ever tested for HIV was independently associated with only race/ethnicity; offered HIV testing in the past year was associated with females, Blacks and Latinos, aged 18-34 years, and having a routine health checkup in past year; any HIV high-risk behavior was associated with only younger age. CONCLUSIONS: To improve HIV testing rates as well as compliance with state laws and national guidelines, targeted efforts should be considered that improve perceptions of risk and emphasize the value of routine HIV screening, including those directed at White adults and their health care providers.

Outbreak of Mycobacterium chelonae infection associated with tattoo ink.

BACKGROUND: In January 2012, on the basis of an initial report from a dermatologist, we began to investigate an outbreak of tattoo-associated Mycobacterium chelonae skin and soft-tissue infections in Rochester, New York. The main goals were to identify the extent, cause, and form of transmission of the outbreak and to prevent further cases of infection. METHODS: We analyzed data from structured interviews with the patients, histopathological testing of skin-biopsy specimens, acid-fast bacilli smears, and microbial cultures and antimicrobial susceptibility testing. We also performed DNA sequencing, pulsed-field gel electrophoresis (PFGE), cultures of the ink and ingredients used in the preparation and packaging of the ink, assessment of source water and faucets at tattoo parlors, and investigation of the ink manufacturer. RESULTS: Between October and December 2011, a persistent, raised, erythematous rash in the tattoo area developed in 19 persons (13 men and 6 women) within 3 weeks after they received a tattoo from a single artist who used premixed gray ink; the highest occurrence of tattooing and rash onset was in November (accounting for 15 and 12 patients, respectively). The average age of the patients was 35 years (range, 18 to 48). Skin-biopsy specimens, obtained from 17 patients, showed abnormalities in all 17, with M. chelonae isolated from 14 and confirmed by means of DNA sequencing. PFGE analysis showed indistinguishable patterns in 11 clinical isolates and one of three unopened bottles of premixed ink. Eighteen of the 19 patients were treated with appropriate antibiotics, and their condition improved. CONCLUSIONS: The premixed ink was the common source of infection in this outbreak. These findings led to a recall by the manufacturer.

Treatment of a mandibular cyst before implant placement: case report.

The aim of this case study is to present a clinical approach to treatment of a mandibular intrabony cyst employing guided bone regeneration principles and protection of the mandibular nerve prior to implant placement. A treatment approach employing a combination of grafting materials and membranes was used to treat the cyst and protect the mandibular nerve prior to implant placement. Micro CT, as well as histology and histomorphometrics, was used to evaluate treatment outcomes. Histological inspection showed bone regeneration at the grafting site. Histomorphometric analysis of the biopsy core rendered a total bone percent area of 58.87% and 41.13% soft tissue. Out of the total bone percent area, 90.45% was revealed as vital bone and 9.55% was graft remnant. The grafted area is supporting an implant-supported prosthesis in full function.

NCCN Guideline Concordance Improves Survival in Pediatric and Young Adult Rectal Cancer.

BACKGROUND: Although management guidelines in adult rectal cancer are widely studied, no consensus guidelines exist for the management of pediatric and young adult rectal cancer. METHODS: The National Cancer Database (2004-2018) was queried for pediatric (age 0-21) and young adult (age 22-40) patients with rectal cancer. Patients were analyzed for receipt of National Comprehensive Cancer Network (NCCN) guideline-concordant therapy. Impact on survival was evaluated using Cox regression and Kaplan-Meier analysis. RESULTS: 6655 patients (108 pediatric and 6547 young adult patients) with rectal cancer were included. Similar to previously published NCCN quality measures with overall guideline concordance approaching 90 % in adults, 89.6 % of pediatric and 84.6 % of young adult patients were classified as receiving pre-operative guideline-concordant therapy. However, pediatric patients were significantly less likely to receive post-operative guideline-concordant therapy than young adult patients (65.3 % verse 76.7 %, respectively, p = 0.008). Risk of death was significantly lower for pediatric patients who received post-operative guideline-concordant therapy (HR, 0.313; CI, 0.168-0.581; p < 0.001). In young adult patients, risk of death was significantly lower for those who received pre-operative guideline-concordant therapy (HR, 0.376, CI 0.338-0.417, p < 0.001), and post-operative guideline-concordant therapy (HR, 0.456; CI 0.413-0.505; p < 0.001). DISCUSSION: NCCN-based guidelines may reasonably guide peri-operative management decisions and improve survival in pediatric and young adult rectal cancer. Given the rarity of this cancer in young patients, employment of an experienced surgical and oncologic multidisciplinary team, along with discussion and involvement of the patient and family, are keys for balancing risks and benefits to offering the best therapeutic strategy. TYPE OF STUDY: Retrospective. LEVEL OF EVIDENCE: Level III.

Calcium Sulfate Disks for Sustained-Release of Amoxicillin and Moxifloxacin for the Treatment of Osteomyelitis.

The purpose of this in vitro study was to develop calcium sulfate (CS)-based disks infused with an antimicrobial drug, which can be used as a post-surgical treatment modality for osteomyelitis. CS powder was embedded with 10% antibiotic, amoxicillin (AMX) or moxifloxacin (MFX), to form composite disks 11 mm in diameter that were tested for their degradation and antibiotic release profiles. For the disk degradation study portion, the single drug-loaded disks were placed in individual meshes, subsequently submerged in phosphate-buffered saline (PBS), and incubated at 37 °C. The disks were weighed once every seven days and analyzed via Fourier-transform infrared spectroscopy, X-ray diffraction, energy dispersive X-ray spectroscopy, and scanning electron microscopy. During the antibiotic release analysis, composite disks were placed in PBS solution, which was changed every 3 days, and analyzed for antibiotic activity and efficacy. The antibacterial effects of these sustained-release composites were tested by agar diffusion assay using Streptococcus mutans (S. mutans) UA 159 as an indicator strain. The degradation data showed significant increases in the degradation of all disks with the addition of antibiotics. Following PBS incubation, there were significant increases in the amount of phosphate and decreases in the amount of sulfate. The agar diffusion assay demonstrated that the released concentrations of the respective antibiotics from the disks were significantly higher than the minimum inhibitory concentration exhibited against S. mutans over a 2-3-week period. In conclusion, CS-antibiotic composite disks can potentially serve as a resorbable, osteoconductive, and antibacterial therapy in the treatment of bone defects and osteomyelitis.

Why we cannot grow a human arm.

There are several significant issues that prevent us from growing a human arm now, or within the next 10-20 years. From a tissue engineering perspective, while we can grow many of the components necessary for construction of a human arm, we can only grow them in relatively small volumes, and when scaled up to large volumes we lack the ability to develop adequate blood/nerve supply. From a genetic engineering perspective, we will probably never be able to turn on the specific genes necessary to "grow an arm" unless it is attached to a fetus and this presents enormous ethical issues related to farming of human organs and structures. Perhaps the most daunting problem facing the transplantation of a tissue engineered or transplanted arm is that of re-innervation of the structure. Since the sensory and motor nerve cells of the arm are located outside of the structure, re-innervation requires those nerves to regenerate over relatively large distances to repopulate the nervous system of the arm. This is something with which we have had little success. We can grow repair parts, but "growing an arm" presents too many insurmountable problems. The best we could possibly do with tissue engineering or genetic engineering would be the equivalent of a fetal arm and the technical problems, costs, and ethical hurdles are enormous. A more likely solution is a functional, permanent, neuroelectronically-controlled prosthesis. These are nearly a reality today.

Socket preservation and sinus augmentation using a medical grade calcium sulfate hemihydrate and mineralized irradiated cancellous bone allograft composite.

Regeneration and preservation of bone after the extraction of a tooth are necessary for the placement of a dental implant. The goal is to regenerate alveolar bone with minimal postoperative pain. Medical grade calcium sulfate hemihydrate (MGCSH) can be used alone or in combination with other bone grafts; it improves graft handling characteristics and particle containment of particle-based bone grafts. In this case series, a 1:1 ratio mix of MGCSH and mineralized irradiated cancellous bone allograft (MICBA) was mixed with saline and grafted into an extraction socket in an effort to maintain alveolar height and width for future implant placement. MGCSH can be used in combination with other bone grafts and can improve handling characteristics and graft particle containment of particle-based bone grafts. In the cases described, we found that an MGCSH:MICBA graft can potentially be an effective bone graft composite. It has the ability to act as a space maintainer and as an osteoconductive trellis for bone cells, thereby promoting bone regeneration in the extraction socket. MGCSH, a cost-effective option, successfully improved MICBA handling characteristics, prevented soft tissue ingrowth, and assisted in the regeneration of bone.

3D printed mesoporous bioactive glass, bioglass 45S5, and ß-TCP scaffolds for regenerative medicine: A comparative in vitro study.

BACKGROUND: While autografts to date remain the "gold standard" for bone void fillers, synthetic bone grafts have garnered attention due to their favorable advantages such as ability to be tailored in terms of their physical and chemical properties. Bioactive glass (BG), an inorganic material, has the capacity to form a strong bond with bone by forming a bone-like apatite surface, enhancing osteogenesis. Coupled with additive manufacturing (3D printing) it is possible to maximize bone regenerative properties of the BG. OBJECTIVE: The objective of this study was to synthesize and characterize 3D printed mesoporous bioactive glass (MBG), BG 45S5, and compare to ß-Tricalcium phosphate (ß-TCP) based scaffolds; test cell viability and osteogenic differentiation on human osteoprogenitor cells in vitro. METHODS: MBG, BG 45S5, and ß-TCP were fabricated into colloidal gel suspensions, tested with a rheometer, and manufactured into scaffolds using a 3D direct-write micro-printer. The materials were characterized in terms of microstructure and composition with Thermogravimetric Analyzer/Differential Scanning Calorimeter (TGA/DSC), Fourier Transform Infrared Spectroscopy (FTIR), X-ray Diffraction (XRD), Micro-Computed Tomography (µ-CT), Scanning Electron Microscopy (SEM), Energy Dispersive X-ray Spectroscopy (EDS), and Mattauch-Herzog-Inductively Coupled Plasma-Mass Spectrometry (MH-ICP-MS). RESULTS: Scaffolds were tested for cell proliferation and osteogenic differentiation using human osteoprogenitor cells. Osteogenic media was used for differentiation, and immunocytochemistry for osteogenic markers Runx-2, Collagen-I, and Osteocalcin. The cell viability results after 7 days of culture yielded significantly higher (p < 0.05) results in ß-TCP scaffolds compared to BG 45S5 and MBG groups. CONCLUSION: All materials expressed osteogenic markers after 21 days of culture in expansion and osteogenic media.

Three-dimensional printing of bone repair and replacement materials: impact on craniofacial surgery.

Solid freeform fabrication techniques such as direct write technology can be used to fabricate tissue-engineering scaffolds in 3 dimensions with high levels of reproducibility and precision. These can comprise complex structures made of osteoconductive, remodelable lattices to conduct bone ingrowth and solid barriers to prevent soft tissue invasion. As such, they act as a combination of bone graft and barrier membrane. Results from animal studies have shown that these structures fill rapidly with healing bone and can conduct bone across critical-size defects to fill large defects in rabbit skull. Results indicate that this technology can be used to produce both off-the-shelf and custom-fabricated bone graft substitutes. These may initially be used to restore alveolar ridge defects, but could also be used, in the future, to repair or replace complex craniofacial bone defects such as cleft palate defects. In the more distant future, these technologies could be combined with controlled-release bioactive substances such as growth factors and pharmaceuticals to regenerate complex structures comprising multiple tissue types.

Bony engineering using time-release porous scaffolds to provide sustained growth factor delivery.

Microporous scaffolds designed to improve bony repair have had limited success; therefore, we sought to evaluate whether time-released porous scaffolds with or without recombinant bone morphogenetic protein 2 (rhBMP-2) could enhance stem cell osteoinduction. Custom-made 15/85 hydroxyapatite/ß-tricalcium phosphate scaffolds were left empty (E) or filled with rhBMP-2 (E+), calcium sulfate (CS), or CS and rhBMP-2 (CS+). All scaffolds were placed in media and weighed daily. Conditioned supernatant was analyzed for rhBMP-2 and then used to feed human adipose-derived mesenchymal stem cells (ASCs). Adipose-derived mesenchymal stem cell ALP activity, OSTERIX expression, and bone nodule formation were determined. E scaffolds retained 97% (SD, 2%) of the initial weight, whereas CS scaffolds had a near-linear 30% (SD, 3%) decrease over 60 days. E+ scaffolds released 155 (SD, 5) ng of rhBMP-2 (77%) by day 2. In contrast, CS+ scaffolds released only 30 (SD, 2) ng (10%) by day 2, and the remaining rhBMP-2 was released over 20 days. Conditioned media from E+ scaffolds stimulated the highest ALP activity and OSTERIX expression in ACSs on day 2. However, after day 6, media from CS+ scaffolds stimulated the highest ALP activity and OSTERIX expression in ASCs. Adipose-derived mesenchymal stem cells exposed to day 8 CS+-conditioned media produced significantly more bone nodules (10.1 [SD, 1.7] nodules per high-power field) than all other scaffolds. Interestingly, day 8 conditioned media from CS scaffolds simulated significantly more bone nodules than either E or E+ scaffold (P < 0.05 for both). Time-released hydroxyapatite/ß-tricalcium phosphate porosity provides sustained growth factor release, enhances ASC osteoinduction, and may result in better in vivo bone formation.

Application of mercury intrusion porosimetry for studying the porosity of mineral trioxide aggregate at two different pH.

OBJECTIVE: To evaluate a novel method of detecting and comparing the porosity of white Mineral Trioxide Aggregate and Portland cement at two different pH. MATERIALS AND METHODS: Cylindrical specimens (n = 120) were prepared from hydrated ordinary white Portland Cement (WPC) (n = 60) and white Mineral Trioxide Aggregate (WMTA) (n = 60) and exposed to environments with pH of 4.4 (n = 30) or 7.4 (n = 30). The pore size distribution and total pore volume were detected using Mercury Intrusion Porosimetry. Data were analyzed by analysis of variance and post-hoc Tukey or Tamhane test (p = 0.05). RESULTS: The pore volume of WMTA was significantly lesser than WPC at both pH (p < 0.05). The surface tension of mercury was taken as 480 (N/m) and the contact angle 141.3° for both materials. Pores were consistently found in all specimens. Total pore volumes for WPC and WMTA (cubic centimeter/gram) were 0.1954 and 0.1023, respectively, while the diameter of the pores ranged from 50-100 Å and 20-50 Å, respectively. CONCLUSIONS: Mercury Intrusion Porosimetry technique is a promising and reliable technique for assessing the porosity of endodontic materials.

A comparison of open and robotic total mesorectal excision for rectal adenocarcinoma.

PURPOSE: This retrospective study was designed to compare open with robot-assisted total mesorectal excision for rectal adenocarcinoma. METHODS: With use of predefined exclusion criteria, all consecutive laparoscopic-assisted (51 patients) and robot-assisted (36 patients) rectal resections for adenocarcinoma from August 2005 to November 2009 at a single institution were considered. Hand-assisted laparoscopy was used for splenic flexure mobilization in all cases. Patients were assigned into robotic and open groups on the basis of the technique used for total mesorectal excision. All 36 robot-assisted resections had the total mesorectal excision performed with robotic assistance and were included in the robotic group. Forty-six of the 51 patients who received a laparoscopic-assisted procedure had the total mesorectal excision performed through the hand port using open surgical technique and were included in the open group. Both groups were compared with respect to patient demographics, perioperative outcomes, and pathology. RESULTS: The robotic and open groups were comparable in age, sex, body mass index, history of prior abdominal surgery, ASA class, number of patients receiving neoadjuvant chemoradiation, and tumor stage. There were more abdominoperineal resections (P = .019) and more low and mid rectal tumors (P = .007) in the robotic group. Total procedure time was longer in the robotic group (P = .003), but blood loss was less (P = .036). Lymph node yield, intraoperative and postoperative complications, and length of stay were all comparable. There were 3 positive circumferential margins in the open group vs none in the robotic group, but this did not reach statistical significance. CONCLUSIONS: Robotic total mesorectal excision is feasible and safe, and is comparable to open total mesorectal excision in terms of perioperative and pathological outcomes. The longer operative time associated with robotic total mesorectal excision could decrease as experience with this relatively new technique increases. Large randomized trials are necessary to validate the potential benefits of less blood loss and lower margin positivity rates observed in this study.

Where is dentistry in regenerative medicine?

Where does dentistry fit into the field of regenerative medicine? Based on the fact that the goal of regenerative medicine is to restore function to damaged organs and tissues, it is apparent that dentistry, which has long embraced the concept of restoring function of damaged teeth, has embraced this goal from the very beginning. In this brief review we present the opinion that if you take as the primary criterion the restoration of tissue and organ function, dentistry has not only been at the forefront of restorative medicine but actually predates it in practice. We illustrate the depth and breadth of dental regenerative medicine using examples of therapies or potential therapies from our laboratories. These begin with an example from a historical area of strength, dental implant design and fabrication, progress to a more high tech bone scaffold fabrication project, and finish with a stem cell-based soft tissue engineering project. In the final analysis we believe that the restorative nature of dentistry will keep it at the forefront of regenerative medicine.

Bone repair in periodontal defect using a composite of allograft and calcium sulfate (DentoGen) and a calcium sulfate barrier.

Deep bone defects are caused by the progression of periodontal disease, which breaks down bone and connective tissue that hold teeth in place. In this case, a 37-year-old male patient presented a deep bone defect with advanced periodontal disease around an upper canine. Medical-grade calcium sulfate was mixed with demineralized freeze-dried bone allograft and used to repair and regenerate the defect. Analysis of the radiographs at the 5-month time point showed the bone had completely regenerated.

Decontamination of the Infected Implant Surface: A Scanning Electron Microscope Study.

A number of treatment options have been explored for peri-implantitis. Seven rough-surfaced implants that failed from peri-implantitis were retrieved. Surfaces were treated by different methods: saline, chlorhexidine, citric acid, 35% phosphoric acid etch gel, hydrogen peroxide, implantoplasty, airborne-particle abrasion, laser, and titanium brush. Implants were observed under scanning electron microscopy. Chemical agents failed to remove any biologic debris. Airborne-particle abrasion, laser, and titanium brush removed part of the biologic debris, and implantoplasty showed complete biologic debris removal. In ex vivo failed implants, implantoplasty showed complete disturbance and removal of bacterial biofilm.

Clinical evaluation of laser microtexturing for soft tissue and bone attachment to dental implants.

INTRODUCTION: A tapered dental implant (Laser-Lok [LL] surface treatment) with a 2 mm wide collar, that has been laser micromachined in the lower 1.5 mm to preferentially accomplish bone and connective tissue attachment while inhibiting epithelial downgrowth, was evaluated in a prospective, controlled, multicenter clinical trial. MATERIALS: Data are reported at measurement periods from 1 to 37 months postoperative for 20 pairs of implants in 15 patients. The implants are placed adjacent to machined collar control implants of the same design. Measurement values are reported for bleeding index, plaque index, probing depth, and crestal bone loss. RESULTS: No statistical differences are measured for either bleeding or plaque index. At all measurement periods there are significant differences in the probing depths and the crestal bone loss differences are significant after 7 months (P < 0.001). At 37 months the mean probing depth is 2.30 mm and the mean crestal bone loss is 0.59 mm for LL versus 3.60 and 1.94 mm, respectively, for control implant. Also, comparing results in the mandible versus those in the maxilla demonstrates a bigger difference (control implant - LL) in the mean in crestal bone loss and probing depth in the maxilla. However, this result was not statistically significant. DISCUSSION: The consistent difference in probing depth between LL and control implant demonstrates the formation of a stable soft-tissue seal above the crestal bone. LL limited the crestal bone loss to the 0.59 mm range as opposed to the 1.94 mm crestal bone loss reported for control implant. The LL implant was found to be comparable with the control implant in safety endpoints plaque index and sulcular bleeding index. There is a nonstatistically significant suggestion that the LL crestal bone retention superiority is greater in the maxilla than the mandible.

In vivo bone response to calcium sulfate/poly L-lactic acid composite.

PURPOSE: Calcium sulfate (CS) is an excellent bone graft material not only because of its osteoconductive, biodegradable, biocompatible, and nontoxic properties, but also because of its angiogenic, barrier membrane, and hemostatic properties. The latter make it unique as a bone graft material. Nevertheless, its clinical use for this purpose is limited by its rapid degradation rate: it usually completely degrades in 4 to 5 weeks, often not enough time for bone to grow into a defect. To overcome this limitation, a CS-based bone graft with a controlled degradation profile was developed. METHODS: A composite of CS and poly (L-lactic acid) (PLLA) (ratio, 96:4) was developed and a degradation profile of the composite generated. Bone response to pure CS and to this composite at time points ranging from 4 to 16 weeks was studied in the rabbit tibial intramedullary canal model. RESULTS: This composite underwent controlled degradation in vitro and in vivo, taking 16 weeks for complete degradation in both cases. It stimulated stronger bone formation in bone defects than did pure CS. CONCLUSION: A CS/PLLA composite (ratio, 96:4) is an excellent bone graft material.

The effects of laser microtextured collars upon crestal bone levels of dental implants.

PURPOSE: The purpose of this study was to examine the crestal bone, connective tissue, and epithelial cell response to a laser microtextured collar compared with a machined collar, in the dog model. MATERIALS: Six mongrel dogs had mandibular premolars and first molars extracted and after healing replaced with BioLok implants 4 x 8 mm. Each dog had 3 control implants placed on one side of the mandible and 3 experimental, laser microtextured, implants placed contralaterally. After 3 months, 1 dog was killed. Bridges were placed on the implants of 4 of the dogs. The sixth dog served as a negative control for the duration of the experiment. Two of the dogs were killed 3 months after loading, of the dogs were killed 6 months after loading as was the negative (unloaded) control. Histology, electron microscopy, and histomorpho-metric analysis was done on histologic sections obtained from block sections of the mandible containing the implants. RESULTS: Initially the experimental implants showed greater bone attachment along the collar. With time the bone heights along the control and experimental collars were equivalent. However, the controls had more soft tissue downgrowth, greater osteoclastic activity, and increased saucerization compared with sites adjacent to experimental implants. There was closer adaptation of the bone to the laser microtextured collars. CONCLUSION: Use of tissue-engineered collars with microgrooving seems to promote bone and soft tissue attachment along the collar and facilitate development of a biological width.

Alkaline phosphatase levels of murine pre-osteoblastic cells on anodized and annealed titanium surfaces.

PURPOSE: This study aimed to evaluate the initial adhesion morphology and alkaline phosphatase (ALP) activity of murine pre-osteoblastic MC3T3-E1 cells cultured on anatase/rutile mixed-phase TiO2 thin films with photocatalytical activity with previously confirmed antibacterial properties. MATERIALS AND METHODS: Anatase/rutile mixed-phase TiO2 thin films fabricated by anodization and annealing of cpTi were used to culture MC3T3-E1 cells to evaluate the initial cellular adhesion morphology and ALP activity in vitro. RESULTS: Compared with MC3T3-E1 cells cultured on cpTi substrates and the control group, cells cultured on anatase/rutile mixed-phase TiO2 thin films exhibited similar ALP levels after cell culture day 9. CONCLUSION: Anodizing and annealing processes fabricate multifunctional surfaces on cpTi with improved osteogenic properties for implants.