Histomorphometric and CBCT comparison of osseointegration around orthodontic titanium miniscrews coated with different nanoparticles: An in-vivo animal study.

BACKGROUND: Temporarily installed titanium orthodontic miniscrews are usually used for many orthodontic applications, especially those cases that need high force, such as skeletally anchored orthodontic appliance cases. Surface modification of titanium miniscrews has proved success in preventing failure and overcoming their limitations. OBJECTIVE: The present study aims at the assessment of the quality of osseointegration of surface modified titanium miniscrews installed in the maxilla of albino rabbits with cone-beam computed tomography (CBCT) imaging as well as histomorphometric investigations. MATERIAL AND METHODS: The orthodontic titanium miniscrews (TMSs) were coated with silver/hydroxyapatite (Ag/HA) nanoparticles (NPs) or zinc oxide (ZnO) NPs via electrochemical deposition. The coating nanomaterials were then characterized with X-ray diffractometry (XRD) and scanning electron microscopy (SEM) imaging. Moreover, the antimicrobial activity of the coated titanium miniscrews were evaluated in the rabbits' oral cavity to investigate their ability to prevent biofilm formation. RESULTS: It was found that the Ag/HA-coated TMSs demonstrated the highest antimicrobial activity and bone area fill, followed by the ZnO NPs-coated TMSs when compared to their uncoated counterparts. In the anterior area surrounding the installed TMSs, the highest osseointegration was demonstrated by ZnO NPs-coated TMSs. However, Ag/HA-coated TMSs showed the highest osseointegration values in the posterior peri-implant area. CONCLUSIONS: Ag/HA- and ZnO NPs-coated TMSs may provide a promising solution to overcome the 30% probable failure in temporarily installed orthodontic miniscrews, as they can enhance the osseointegration process and prevent biofilm formation.

A Novel Approach of Periodontal Osseous Wall Piezosplitting and Sequential Bone Expansion in Management of Localized Intra-Bony Defects with Wide Angulation-A Randomized Controlled Trial.

Piezoelectric surgical instruments with various mini-sized tips and cutting technology offer a precise and thin cutting line that could allow the wider use of periodontal osseous wall swaging. This randomized controlled trial was designed to investigate the use of a minimally invasive piezo knife to harvest vascularized interseptal bone pedicles in treating intra-bony defects. Sixteen non-smoking patients (mean age 39.6 ± 3.9) with severe chronic periodontitis were randomly assigned into one of two groups (N = 8). The Group 1 (control) patients were treated by bone substitute grafting of the intra-bony defect, whereas the Group 2 patients were treated by intra-bony defect osseous wall swaging (OWS) combined with xenograft filling of the space created by bone tilting. In both groups, the root surfaces were treated with a neutral 24% EDTA gel followed by saline irrigation. Clinical and radiographic measurements were obtained at baseline and 6 months after surgery. The sites treated with osseous wall swaging showed a statistically significant probing-depth reduction and increase in clinical attachment compared with those of the Group 1 patients. The defect base level was significantly reduced for the OWS group compared to that of the Group 1 control. By contrast, the crestal bone level was significantly higher in the OWS group compared to Group 1. The crestal interseptal bone width was significantly higher in Group 2 at 6 months compared to the baseline value and to that of Group 1 (<0.001). The osseous wall swaging effectively improved the clinical hard- and soft-tissue parameters. The use of mini inserts piezo-cutting, sequential bone expanders for osseous wall redirection, and root surface EDTA etching appears to be a reliable approach that could allow the use of OWS at any interproximal dimension.