Bacterial attachment on titanium surfaces is dependent on topography and chemical changes induced by nonthermal atmospheric pressure plasma.

Here, we investigated the antibacterial effects of chemical changes induced by nonthermal atmospheric pressure plasma (NTAPP) on smooth and rough Ti. The morphologies of smooth and rough surfaces of Ti were examined using scanning electron microscopy (SEM). Both Ti specimens were then treated for 10 min by NTAPP with nitrogen gas. The surface roughness, chemistry, and wettability were examined by optical profilometry, x-ray photoelectron spectroscopy, and water contact angle analysis, respectively. Bacterial attachment was measured by determining the number of colony forming units and by SEM analysis. The rough Ti showed irregular micropits, whereas smooth Ti had a relatively regular pattern on the surface. There were no differences in morphology between samples before and after NTAPP treatment. NTAPP treatment resulted in changes from hydrophobic to hydrophilic properties on rough and smooth Ti; rough Ti showed relatively higher hydrophilicity. Before NTAPP treatment, Streptococcus sanguinis (S. sanguinis) showed greater attachment on rough Ti, and after NTAPP treatment, there was a significant reduction in bacterial attachment. Moreover, the bacterial attachment rate was significantly lower on rough Ti, and the structure of S. sanguinis colonies were significantly changed on NTAPP-treated Ti. NTAPP treatment inhibited bacterial attachment surrounding titanium implants, regardless of surface topography. Therefore, NTAPP treatment on Ti is a next-generation tool for antibacterial applications in the orthopaedic and dental fields.

Evaluation of the accuracy and precision of four intraoral scanners with 70% reduced inlay and four-unit bridge models of international standard.

The aims of this study were to evaluate the feasibility of 70% reduced inlay and 4-unit bridge models of International Standard (ISO 12836) assessing the accuracy of laboratory scanners to measure the accuracy of intraoral scanner. Four intraoral scanners (CS3500, Trios, Omnicam, and Bluecam) and one laboratory scanner (Ceramill MAP400) were used in this study. The height, depth, length, and angle of the models were measured from thirty scanned stereolithography (STL) images. There were no statistically significant mean deviations in distance accuracy and precision values of scanned images, except the angulation values of the inlay and 4-unit bridge models. The relative errors of inlay model and 4-unit bridge models quantifying the accuracy and precision of obtained mean deviations were less than 0.023 and 0.021, respectively. Thus, inlay and 4-unit bridge models suggested by this study is expected to be feasible tools for testing intraoral scanners.

Titanium-Silver Alloy Miniplates for Mandibular Fixation: In Vitro and In Vivo Study.

PURPOSE: Titanium (Ti) alloys have received considerable attention as materials for oral and maxillofacial surgery, which require high mechanical strength, osteosynthesis, and biocompatibility. The objective was to implant miniplates fabricated from commercially pure Ti (CP Ti) and newly developed Ti-silver (Ag) alloy in fractured mandibles of adult dogs after preliminary mechanical and biological characterization. MATERIALS AND METHODS: The surface characteristics, biocompatibility, and pre-osteoblast adhesion and proliferation of CP Ti (grade 3) and Ti-Ag (2 at% Ag) alloys were evaluated. Next, the bending strength of 6- and 8-hole miniplates fabricated from CP Ti and Ti-Ag was compared according to ISO (International Organization for Standardization) 9585. Six-hole miniplates were implanted for 12 weeks in fractured mandibles of adult dogs. The Ag ion concentration in each alloy and implanted bone block with soft tissue was measured by inductively coupled plasma mass spectroscopy after euthanasia according to ISO 10993-12. RESULTS: Precipitated Ag was detected in Ti-Ag by alpha- and beta-phase Ti in x-ray powder diffraction. The biocompatibility with pre-osteoblasts of Ti-Ag and CP Ti was comparable in terms of cytotoxicity, cell adhesion, and proliferation (P > .05). Ti-Ag miniplates had up to 3-fold greater bending strength than CP Ti miniplates (P < .05). An in vivo study showed that CP Ti and Ti-Ag miniplates had comparable soft and hard tissue regeneration ability (P > .05). Ag ions were detected in Ti-Ag alloys and applied mandible blocks. CONCLUSIONS: The results of this study suggest that Ti-Ag alloys can be used to produce miniplates with high mechanical properties, as well as considerable biocompatibility, osteosynthesis ability, and Ag ion-release properties. Further studies, including preclinical investigations, are required to enable clinical use of Ti-Ag bone plates.

Effect of the Crystallization Process on the Marginal and Internal Gaps of Lithium Disilicate CAD/CAM Crowns.

The aim of this study is to quantify the effect of the crystallization process on lithium disilicate ceramic crowns fabricated using a computer-aided design/computer-aided manufacturing (CAD/CAM) system and to determine whether the effect of crystallization is clinically acceptable by comparing values of fit before and after the crystallization process. The mandibular right first molar was selected as the abutment for the experiments. Fifteen working models were prepared. Lithium disilicate crowns appropriate for each abutment were prepared using a commercial CAD/CAM system. Gaps in the marginal area and 4 internal areas of each crown were measured twice-before and after crystallization-using the silicone replica technique. The mean values of fit before and after crystallization were analyzed using a paired t-test to examine whether the conversion that occurred during crystallization affected marginal and internal gaps (α = 0.05). Gaps increased in the marginal area and decreased in the internal areas after crystallization. There were statistically significant differences in all of the investigated areas (P < 0.05). None of the values for marginal and internal fit of lithium disilicate CAD/CAM crowns after crystallization exceeded 120 µm, which is the clinically acceptable threshold.

Long-Term Antibacterial Performance and Bioactivity of Plasma-Engineered Ag-NPs/TiO2

We prepared TiO2 nanotubes (NT) on commercially pure titanium (cp-Ti) substrate by plasma electrolyte oxidation and adapted magnetron sputtering for incorporation of Ag-nanoparticles (Ag-NPs) onto the nanotubes (Ag-NPs/TiO2 nanotube). Power input to the Ag target per unit time was varied (5, 10, 15 W/cm2) to fabricate different shapes of Agnanoparticles onto the nanotubes while net energy input was fixed by maintaining a constant total sputter time (30, 15, 10 s, respectively). For investigation of experimental samples' characteristics, FE-SEM, TEM, EDS, XRD, XPS, SPM analysis and contact angles measurement was carried out. Through these characterization, plasma engineered Ag-NPs was successfully formed on/in the entire nanotube structure. In terms of antibacterial ability, plasma engineered Ag-NPs/TiO2 nanotubes samples significantly reduced S. aureus colony numbers compared with control. Also, simulated body fluid immersion tests with hydroxyapatite showed ion precipitation onto the surface of all experimental groups, confirmed by XRD and EDS analysis. However, plasma engineered Ag-NPs/TiO2 nanotubes groups were not cytotoxic. Furthermore, MC3T3-E1 cells were cultured on Ag-NPs/TiO2 nanotubes groups to evaluate the effect of nanostructured surface on cell functionality such as a cell proliferation and ALP activity. Ag-NPs/TiO2 nanotubes have both biocompatible and antibacterial characteristics.

The Study on Inhibition of Planktonic Bacterial Growth by Non-Thermal Atmospheric Pressure Plasma Jet Treated Surfaces for Dental Application.

Investigation of the effects by non-thermal atmospheric pressure plasma jet (NTAPPJ) treatment on the titanium dental implant surfaces for the inhibition of two common pathogens related with dental infections, Streptococcus mutans and Staphylococcus aureus, was carried out in this study. The commercially pure titanium was used as specimen, which were irradiated by NTAPPJ for 30, 60 and 120 seconds. Specimen without being treated with NTAPPJ was assigned as the control group. The X-ray photoelectron spectroscope and surface contact angle goniometer were used to analyze the effects of NTAPPJ treatment on surface chemistry and hydrophilicity of the specimen. The effects of the NTAPPJ treatment on surfaces, in terms of bacterial attachment, growth, morphology and structural changes were evaluated by the number of colony forming units (CFU) and scanning electron microscopy (SEM) observations. The results showed that there was a reduction of CFUs and the significant change in morphology of bacteria as they were cultured on the titanium surfaces treated with NTAPPJ. These results were related to surface chemical changes and hydrophilicity changes by NTAPPJ. The NTAPPJ treatment is very effective on the dental implant titanium surface treatment that resulted in the inhibition of bacteria and has a great potential to be a promising technique in various clinical dental applications.

An Alternative to Annealing TiO2 Nanotubes for Morphology Preservation: Atmospheric Pressure Plasma Jet Treatment.

Titanium oxide nanotube layer formed by plasma electrolytic oxidation (PEO) is known to be excellent in biomaterial applications. However, the annealing process which is commonly performed on the TiO2 nanotubes cause defects in the nanotubular structure. The purpose of this work was to apply a non-thermal atmospheric pressure plasma jet on diameter-controlled TiO2 nanotubes to mimic the effects of annealing while maintaining the tubular structure for use as biomaterial. Diameter-controlled nanotube samples fabricated by plasma electrolytic oxidation were dried and prepared under three different conditions: untreated, annealed at 450 °C for 1 h in air with a heating rate of 10 °C/min, and treated with an air-based non-thermal atmospheric pressure plasma jet for 5 minutes. The contact angle measurement was investigated to confirm the enhanced hydrophilicity of the TiO2 nanotubes. The chemical composition of the surface was studied using X-ray photoelectron spectroscopy, and the morphology of TiO2 nanotubes was examined by field emission scanning electron microscopy. For the viability of the cell, the attachment of the osteoblastic cell line MC3T3-E1 was determined using the water-soluble tetrazolium salt assay. We found that there are no morphological changes in the TiO2 nanotubular structure after the plasma treatment. Also, we investigated a change in the chemical composition and enhanced hydrophilicity which result in improved cell behavior. The results of this study indicated that the non-thermal atmospheric pressure plasma jet results in osteoblast functionality that is comparable to annealed samples while maintaining the tubular structure of the TiO2 nanotubes. Therefore, this study concluded that the use of a non-thermal atmospheric pressure plasma jet on nanotube surfaces may replace the annealing process following plasma electrolytic oxidation.

Fabrication of bioactive, antibacterial TiO2 nanotube surfaces, coated with magnetron sputtered Ag nanostructures for dental applications.

We investigated whether a silver coating on an anodic oxidized titania (TiO2) nanotube surface would be useful for preventing infections in dental implants. We used a magnetron sputtering process to deposit Ag nanoparticles onto a TiO2 surface. We studied different sputtering input power densities and maintained other parameters constant. We used scanning electron microscopy, X-ray diffraction, and contact angle measurements to characterize the coated surfaces. Staphylococcus aureus was used to evaluate antibacterial activity. The X-ray diffraction analysis showed peaks that corresponded to metallic Ag, Ti, O, and biocompatible anatase phase TiO2 on the examined surfaces. The contact angles of the Ag nanoparticle-loaded surfaces were significantly lower at 2.5 W/cm2 input power under pulsed direct current mode compared to commercial, untreated Ti surfaces. In vitro antibacterial analysis indicated that a significantly reduced number of S. aureus were detected on an Ag nanoparticle-loaded TiO2 nanotube surface compared to control untreated surfaces. No cytotoxicity was noted, except in the group treated with 5 W/cm2 input power density, which was the highest input of power density we tested for the magnetron sputtering process. Overall, we concluded that it was feasible to create antibacterial Ag nanoparticle-loaded titanium nanotube surfaces with magnetron sputtering.

Tailoring of antibacterial Ag nanostructures on TiO2 nanotube layers by magnetron sputtering.

To reduce the incidence of postsurgical bacterial infection that may cause implantation failure at the implant-bone interface, surface treatment of titanium implants with antibiotic materials such as silver (Ag) has been proposed. The purpose of this work was to create TiO2 nanotubes using plasma electrolytic oxidation (PEO), followed by formation of an antibacterial Ag nanostructure coating on the TiO2 nanotube layer using a magnetron sputtering system. PEO was performed on commercially pure Ti sheets. The Ag nanostructure was added onto the resulting TiO2 nanotube using magnetron sputtering at varying deposition rates. Field emission scanning electron microscopy and transmission electron microscopy were used to characterize the surface, and Ag content on the TiO2 nanotube layer was analyzed by X-ray diffraction and X-ray photoelectron spectroscopy. Scanning probe microscopy for surface roughness and contact angle measurement were used to indirectly confirm enhanced TiO2 nanotube hydrophilicity. Antibacterial activity of Ag ions in solution was determined by inductively coupled plasma mass spectrometry and antibacterial testing against Staphylococcus aureus (S. aureus). In vitro, TiO2 nanotubes coated with sputtered Ag resulted in significantly reduced S. aureus. Cell viability assays showed no toxicity for the lowest sputtering time group in the osteoblastic cell line MC3T3-E1. These results suggest that a multinanostructured layer with a biocompatible TiO2 nanotube and antimicrobial Ag coating is a promising biomaterial that can be tailored with magnetron sputtering for optimal performance.