Promoting the adhesion of human gingival epithelial cells on titanium surface by non-thermal atmospheric plasma irradiation.

OBJECTIVES: This work aimed to study the biological behavior of human gingival epithelial cells (HGECs) irradiated by non-thermal atmospheric plasma (NTAP) on a titanium surface. METHODS: Cultured HGECs (3⁃5 generations) with the best activity were digested and treated for varying times (0, 10, 20, 30, and 60 s) by NTAP and then seeded on the surface of a titanium disc. The HGECs were cultured in oral keratinocyte medium and 1% penicillin/streptomycin solution. The cells were kept in an atmosphere of 5% CO2 at 37 ℃ and incubated for different times (4, 12, 24, and 48 h; n=5). Cell counting kit-8 (CCK-8) was used to detect cell adhesion capacity. Scanning electron microscopy (SEM) was conducted to observe the morphology of cells on titanium plates. Quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot were used to evaluate the gene expression of adhesion-related molecules, such as Laminin α3, Integrin ß4, and Plectin. RESULTS: The number of adhered cells increased at 0­20 s, whereas that gradually decreased at 20⁃60 s. Therefore, cell culture at the two time points showed that HGECs adhesion reached the maximum when NATP was irradiated for 20 s. Compared with the control group, more cells in the treatment group adhered to the titanium surface at each time point (P<0.05). Cells in the treatment group showed more irregular polygons, more protrusions and pseudopods, and a larger cell diffusion area on the titanium surface than those in the control group. qRT-PCR showed that the expression levels of Laminin α3, Integrin ß4, and Plectin adhesion-related genes on the titanium surface in the treatment group were higher than those in the control group at each culture time point (P<0.05). Western blot showed that the expression levels of Laminin α3, Integrin ß4, and Plectin adhesion-related proteins on the titanium surface were higher in the treatment group than in the control group at 4 and 12 h. CONCLUSIONS: After NTAP treatment, the results showed that 20 s of treatment time could maximize the number of adhered cells on the titanium surface; change the cell adhesion morphology; and significantly upregulate the expression of adhesion-related genes and proteins of Laminin α3, Integrin ß4, and Plectin. Furthermore, it could promote the biological sealing effect of HGECs on the titanium surface.

Nonthermal Plasma Brush Treatment on Titanium and Zirconia To Improve Periabutment Epithelium Formation.

The peri-implant soft tissue with inferior adhesion takes a long healing period to form, which is undesirable for the reaction around the peri-implant soft tissues. The aim of this study is to improve the physicochemical properties of titanium (Ti) and zirconia (ZrO2) implant abutments and shorten the formation period of periabutment epithelium tissue. A nonthermal atmospheric plasma brush (NTAPB, N) was employed for Ti and ZrO2 activation. The surface topographies, roughness, crystallinity, wettability, and chemical elements of the abutment materials were examined. The epithelial cell behavior analysis and tissue remodeling of the periabutment epithelial tissue were performed in vitro and in vivo. N-Ti and N-ZrO2 had a similar good surface wettability, with a 65 and 70% increase in oxygen content and a 70 and 75% decrease in carbon content, respectively. Both N-Ti and N-ZrO2 showed excellent adhesion, spread, and proliferation of epithelial cells in vitro, with improved adhesion molecule expression levels compared to untreated samples. N-Ti and N-ZrO2 abutments were placed in the implantation sites of rats. From week 2 to week 6 after implantation, N-Ti and N-ZrO2 had similar periabutment epithelium tissue formation, and both had increased plectin-positive and laminin γ2-positive cell numbers compared to Ti and ZrO2. The NTAPB shows promising abutment modification abilities. It promotes the expression levels of adhesion molecules and the epithelial cell performance, which later leads to a quicker formation and remodeling of the important periabutment epithelial tissue.

The biological width around implant.

PURPOSE: The concept of biological width has been proposed and widely used in oral implantation. This review aimed to summarize the biological width around implant in detail. STUDY SELECTION: An electronic search of the literature prior to March 2019 was performed to identify all articles related to biological width in periimplant soft tissue. The search was conducted in the MEDLINE (National Library of Medicine) database accessed through PubMed with no date restriction. The following main keywords were used: "implant", "biological width", "soft tissue", "junctional epithelium", "peri-implant epithelium", "connective tissue", "gingiva", "mucosa" (connecting multiple keywords with AND, OR). RESULTS: The identified researches focused on several aspects related to biological width in oral implantation, namely the concept, formation, remodeling, dimension, structure and function. CONCLUSIONS: Based on of the reviewed literature, the concept, formation, remodeling, structure, dimension, and functional significances of periimplant biological width are explored in this narrative review. The formation of biological width around implant is a complex process after several weeks of healing. The biological width around implant is a 3-4mm distance from the top of the peri-implant mucosa to the first bone-to-implant contact or the stabilized top of the adjacent bone, consisting of sulcular epithelium, junctional epithelium and fibrous connective tissue between the epithelium and the first bone-to-implant contact or the stabilized top of the adjacent bone. The biological width forms a biological barrier against the bacteria, influences the remodeling of soft and hard tissue around implant and has implications for clinical aspects of dental implantation.

[Research progress on the osseointegration of titanium implants promoted by cold atmospheric plasma].

The application of cold atmospheric plasma to titanium surface modification has recently become a research focus in the area of material modification. Previous studies found that cold atmospheric plasma can affect the colonization of bacteria and biological behaviors of osteoblasts by changing the surface characteristics of titanium in vitro. In vivo studies reveal that cold atmospheric plasma can promote the process of osseointegration of titanium implants. This review focuses on research on the effects of the surface modification of titanium implants with cold atmospheric plasma on osseointegration.

Effects of novel non-thermal atmospheric plasma treatment of titanium on physical and biological improvements and in vivo osseointegration in rats.

Titanium (Ti) has achieved extensive applications due to its excellent biocompatibility and mechanical properties. Plasma can enhance surface hydrophilia of Ti with decreased carbon contamination. The traditional conditions using a single gas plasma was for longer treatment time and more prone to being contaminated. We designed and developed novel and universal apparatus and methods with a special clamping device of non-thermal atmospheric plasma (NTAP) treatment using mixed gas for Ti surface activation. We systematically and quantitatively investigated the effective effects of NTAP-Ti. The surface water contact angle decreased by 100%, the carbon content decreased by 80% and oxygen content increased by 50% in the novel NTAP-Ti surfaces. NTAP treatment accelerated the attachment, spread, proliferation, osteogenic differentiation and mineralization of MC3T3-E1 mouse preosteoblasts in vitro. The percentage of bone-to-implant contact increased by 25-40%, and the osteoclasts and bone resorption were suppressed by 50% in NTAP-Ti in vivo. In conclusion, NTAP-Ti substantially enhanced the physical and biological effects and integration with bone. The novel and universal apparatus and methods with a special clamping device using gas mixtures are promising for implant activation by swiftly and effectively changing the Ti surface to a hydrophilic one to enhance dental and orthopedic applications.

Proposal and In-Depth Analysis of Emergency Treatment Procedures for Removing Fractured Abutments in Implants With Tapped-In Connections: Case Report.

In implant-supported prostheses, the most frequently reported mechanical complications after implant restoration are loosening or fracture of abutments or screws. Such complications have serious consequences, and removal of fractured abutments or screws is difficult. There are various methods to remove fractured abutment screws in implants with screwed-in connections. However, no approach has been reported to retrieve solid abutments in implants with a locking-taper implant-abutment connection, which are rarely observed in clinical settings. This study presents the case of a 62-year-old male patient with a fractured abutment in an upper-right second premolar implant. Abutment fracture is a common mechanical complication after dental implantation. Parafunctional habits and occlusal overloading may generate excessive occlusal forces, which increase the risk of mechanical complications. This report presents a series of emergency procedures for removing a fractured solid abutment and fabricating a new prosthesis to restore the edentulous area. In this retrospective analysis, the authors deeply consider the whole treatment, through which the deficiencies of the treatment are noted, and corresponding future directions are discussed. This case report presents a convenient approach to removing a solid abutment in a sudden emergency, discusses possible reasons for solid abutment fractures, designs a new rescue kit for easy retrieval of such abutments and summarizes a valid solution for removing fractured solid abutments.

Non-thermal plasma reduces periodontitis-induced alveolar bone loss in rats.

Periodontitis, a chronic infectious disease induced by microbial biofilm, is one of the most common diseases worldwide. Scaling and root planning (SRP) has always been recognized as the typical treatment. However, the therapeutic efficiency is often limited due to the intraoperative bleeding and the limitations of instruments. Non-thermal atmospheric plasma (NTP) appears to be a potential tool for periodontitis due to its promising biofilm degradation and decontamination effects. In this study, we investigated the role of NTP, as an adjuvant approach for the treatment of ligature-induced periodontitis in rats. Herein we showed that SRP or SRP-NTP application attenuated the periodontitis-induced alveolar bone loss, reflected by the increased BV/TV value and the decreased CEJ-AB distance, which might be related to the lower detection rate of periodontal pathogen in SRP and SRP-NTP groups. Besides, SRP-NTP rats showed less bone loss and lower CEJ-AB distance than that of SRP group at 30d post treatment, indicating a more comprehensive and long-lasting effect of SRP-NTP. A remarkable decrease of osteoclast number and lower expression of RANKL was also detected in SRP-NTP rats. In addition, expression of inflammatory-related cytokines such as TNF-α and IL-1ß decreased significantly in SRP-NTP group, while IL-10 level increased substantially. These results together illustrated that a combination of SRP and NTP treatment was an effective way to prevent periodontitis progress, which reduced alveolar bone loss and promoted periodontium restoration in ligature-induced periodontitis rats. In conclusion, non-thermal plasma treatment may be considered as a feasible and effective supplementary approach to control periodontitis.