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Dental implants are frequently used to support fixed or removable dental prostheses to replace missing teeth. The clinical success of titanium dental implants is owed to the exceptional biocompatibility and osseointegration with the bone. Therefore, the enhanced therapeutic effectiveness of dental implants had always been preferred. Several concept...
Contexts in source publication
Context 1
... addition to excellent biocompatibility, the dental implant coating is desired to improve the tissue-biomaterial interface and to enhance osseointegration. Consequently, bioactive material coatings are known to encourage bone formation and are preferred over bioinert and biotolerant coatings (Figure 4). As discussed earlier, osseointegration is essential for the stability and clinical success of implants. ...
Context 2
... to the original definition, osseointegration is the direct contact between bone and a loaded implant surface at the microscopic level [14]; however, more recently, it is described as an immune-driven demarcation response (type IV hypersensitivity) to a foreign body Ti implant that is immovable (ankylose) in bone [114]. This biotolerant nature of commercially pure Ti encourages contact osteogenesis [115] due to close apposition of the bone on their surface (Figure 4). It is well established that Ti is stable in a biological environment and does not trigger a foreign body reaction. ...
Citations
... In recent years, replacing missing teeth with fixed or removable dental prosthesis supported by dental implants has gained popularity. 1 Dental implants have emerged as a predictable treatment modality to accomplish good functional and aesthetic outcomes. 2 They are surgically inserted into the jawbone and should be in direct contact with bone under ideal circumstances, which is referred to as osseointegration. ...
Objective: Recent years have seen a rise in the usage of dental implants to restore lost teeth. The stability of a dental implant is the main factor in determining its success. Implant stability is influenced by various factors. Several approaches have been employed clinically to evaluate stability at different time intervals. One non-invasive way to assess implant stability is by resonance frequency analysis. Utilizing the resonance frequency analysis method, this study seeks to understand how implant length and diameter affect primary and secondary stability. Methods: The current prospective study was conducted in the Prosthodontics Department of Institute of Dentistry, CMH Lahore Medical College. The duration of the study was six months. A total of 90 implants of sizes 4.5 x 8.5 mm and 4 x 10mm were placed. Resonance frequency measurements were recorded using OsstellTM AB device for primary stability at implant insertion and at 12 weeks for secondary stability. All the measurements were carried out by only one of the researchers to minimize inter-observer bias. Results: The average primary stability was 70.33±6.60, and the average secondary stability was 71.43±5.44. The data was stratified for age, gender, and implant site, and the mean primary and secondary stability of both sizes didn’t show any statistically significant differences. Conclusion: Without forfeiting implant stability, both implant sizes (4x10mm and 4.5x8.5mm) can be used interchangeably, depending on available space and anatomical constraints. doi: https://doi.org/10.12669/pjms.40.6.8213 How to cite this: Khan MW, Inayat N, Zafar MS, Zaigham AM. A resonance frequency analysis to investigate the impact of implant size on primary and secondary stability. Pak J Med Sci. 2024;40(6):1261-1266. doi: https://doi.org/10.12669/pjms.40.6.8213 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
... By localizing antibiotic action to the implant site, integrated coatings can significantly reduce the potential for systemic side effects compared to oral or injectable antibiotics [101]. Antibiotic coatings are effective in preventing the formation of biofilms, a leading cause of implant failure, by killing bacteria before they can settle and multiply on the implant surface [100,101]. ...
... By localizing antibiotic action to the implant site, integrated coatings can significantly reduce the potential for systemic side effects compared to oral or injectable antibiotics [101]. Antibiotic coatings are effective in preventing the formation of biofilms, a leading cause of implant failure, by killing bacteria before they can settle and multiply on the implant surface [100,101]. Localized use of antibiotics (e.g., at the implant site) can help mitigate the broader issue of antibiotic resistance by reducing the unnecessary systemic use of antibiotics [100,101]. ...
... Antibiotic coatings are effective in preventing the formation of biofilms, a leading cause of implant failure, by killing bacteria before they can settle and multiply on the implant surface [100,101]. Localized use of antibiotics (e.g., at the implant site) can help mitigate the broader issue of antibiotic resistance by reducing the unnecessary systemic use of antibiotics [100,101]. ...
During surgery and after, pathogens can contaminate indwelling and implanted medical devices, resulting in serious infections. Microbial colonization, infection, and later biofilm formation are major complications associated with the use of implants and represent major risk factors in implant failure. Despite the fact that aseptic surgery and the use of antimicrobial medications can lower the risk of infection, systemic antibiotic use can result in a loss of efficacy, increased tissue toxicity, and the development of drug-resistant diseases. This work explores the advancements in antimicrobial coatings for head-related implantable medical devices, addressing the critical issue of infection prevention. It emphasizes the significance of these coatings in reducing biofilm formation and microbial colonization and highlights various techniques and materials used in creating effective antimicrobial surfaces. Moreover, this article presents a comprehensive overview of the current strategies and future directions in antimicrobial coating research, aiming to improve patient outcomes by preventing head-related implant-associated infections.
... A promising strategy to develop active surfaces involves the controlled release of various active agents, such as drugs, growth factors, proteins, peptides, nucleic acids, and even silver nanoparticles [54]. This controlled release occurs from a variety of platforms, including hydrogels and nanogels, polymer multilayers and cyclodextrines and enables the desired surface response [129][130][131]. These structures, which are built upon polymers and proteins, serve as remarkably versatile reservoirs capable of releasing bioactive molecules (Figure 7). ...
This paper reviews different approaches to obtain biomaterials with tailored functionalities and explains their significant characteristics that influence their bioactivity. The main goal of this discussion underscores the significance of surface properties in materials, with a particular emphasis on their role in facilitating cell adhesion in order to obtain good biocompatibility and biointegration, while preventing adverse effects, such as bacterial contamination and inflammation processes. Consequently, it is essential to design strategies and interventions that avoid bacterial infections, reducing inflammation and enhancing compatibility systems. Within this review, we elucidate the most prevalent techniques employed for surface modification, notably emphasizing surface chemical composition and coatings. In the case of surface chemical composition, we delve into four commonly applied approaches: hydrolysis, aminolysis, oxidation, and plasma treatment. On the other hand, coatings can be categorized based on their material composition, encompassing ceramic-based and polymer-based coatings. Both types of coatings have demonstrated efficacy in preventing bacterial contamination, promoting cell adhesion and improving biological properties of the surface. Furthermore, the addition of biological agents such as drugs, proteins, peptides, metallic ions plays a pivotal role in manifesting the prevention of bacterial infection, inflammatory responses, and coagulation mechanism.
... For example, a coating of bioactive materials (calcium phosphates and hydroxyapatite (HA)) increases the bioactivity of the surface, improving osteointegration. Bisphosphonate coatings are designed to stimulate osteoblasts and inhibit osteoclast activity and bone resorption, and implants coated with gentamicin and polylactic acid have antimicrobial effects [45]. ...
Successful implantation in augmented areas relies on adequate bone density and quality, along with thorough planning. The minimisation of the risks involved in the surgery and recovery phases is also of tremendous relevance. The aims of the present research were to clinically and biochemically evaluate the healing process after implant surgery (dental implants) using dynamic surgical navigation following prior bone augmentation. Thirty healthy patients who had implant treatment were analysed. The study participants (30 patients) were randomised between two groups. The 15 patients in the study group were treated with Navident dynamic navigation by using a flapless technique. The control group included 15 subjects in whom the implantation procedure was performed classically using the elevation flap full-thickness method. In all cases, the patient’s clinical condition, the patient’s subjective visual assessment of post-operative pain using the Visual Analogue Scale (VAS), and the levels of the salivary biomarkers interleukin 6 (IL 6) and C-reactive protein (CRP) immediately before surgery on the first post-operative day and on the seventh post-operative day were assessed. The healing process was shown to be faster in patients in the study group due to the low invasiveness of the treatment, which was confirmed by lower levels of pro-inflammatory cytokines in the study group versus the control group. The statistical analysis used Student’s t-test and Mann–Whitney test. The implementation of dynamic navigation and the application of the flapless technique reduced post-operative trauma, leading to a reduced risk of infection, reduced patient discomfort, and faster recovery.
... However, dental implant therapy has appeared to be more challenging in medically compromised patients (diabetes, osteoporosis, bleeding disorders and hypothyroidism). (4,5) Therefore, attempts are conducted to achieve more rapid and stable osseointegration. (1) Osseointegration is influenced by many factors including: implant biocompatibility, fixture design, surface characteristics, surgical techniques, health state of host, biomechanical status, and time. ...
... In order to highly advance surface properties in dental implant devices, coatings have been proposed over the substrate aiming changes at a micron or nano-scaled level to stimulate positive tissue response and/ or mimic tissue architecture [89,90]. Coatings have been developed using a diversity of organic and synthetic materials such as polymers, biomolecules, drugs, minerals, among others [89,90]. ...
... In order to highly advance surface properties in dental implant devices, coatings have been proposed over the substrate aiming changes at a micron or nano-scaled level to stimulate positive tissue response and/ or mimic tissue architecture [89,90]. Coatings have been developed using a diversity of organic and synthetic materials such as polymers, biomolecules, drugs, minerals, among others [89,90]. The approach to deposit a coating over the substrate is focused on changing some of the surface properties such as wettability conditions, biocompatibility, morphology, and chemical composition [89][90][91]. ...
... Coatings have been developed using a diversity of organic and synthetic materials such as polymers, biomolecules, drugs, minerals, among others [89,90]. The approach to deposit a coating over the substrate is focused on changing some of the surface properties such as wettability conditions, biocompatibility, morphology, and chemical composition [89][90][91]. Additionally, the application of coatings loaded with different substances has shown promising and superior outcomes in terms of cellular viability and/or antibacterial properties compared to non-coated surfaces [91,92]. ...
Objectives
Trans-mucosal platforms connecting the bone-anchored implants to the prosthetic teeth are essential for the success of oral rehabilitation in implant dentistry. This region promotes a challenging environment for the successfulness of dental components due to the transitional characteristics between soft and hard tissues, the presence of bacteria, and mechanical forces. This review explored the most current approaches to modify trans-mucosal components in terms of macro-design and surface properties.
Methods
This critical review article revised intensely the literature until July 2023 to demonstrate, discuss, and summarize the current knowledge about marketable and innovative trans-mucosal components for dental implants.
Results
A large number of dental implant brands have promoted the development of several implant-abutment designs in the clinical market. The progress of abutment designs shows an optimistic reduction of bacteria colonization underlying the implant-abutment gap, although, not completely inhibited. Fundamental and preclinical studies have demonstrated promising outcomes for altered-surface properties targeting antibacterial properties and soft tissue sealing. Nanotopographies, biomimetic coatings, and antibiotic-release properties have been shown to be able to modulate, align, orient soft tissue cells, and induce a reduction in biofilm formation, suggesting superior abilities compared to the current trans-mucosal platforms available on the market.
Significance
Future clinical implant-abutments show the possibility to reduce peri-implant diseases and fortify soft tissue interaction with the implant-substrate, defending the implant system from bacteria invasion. However, the absence of technologies translated to commercial stages reveals the need for findings to “bridge the gap” between scientific evidences published and applied science in the industry.
... These advantages prompted us to further explore the feasibility of applying the complex onto the surfaces of titanium implants. The advantages of creating a local drug delivery system on the titanium implant surface include low local dose and high targeting; however, the drug release kinetics must be controlled to avoid the abrupt release of high concentrations of drugs [40]. Additionally, it is necessary to develop a slow-release drug system with optimum bioavailability because of the poor water solubility and low bioavailability of RA-Zn. ...
... HA is a form of CaP and the substance that makes up a major inorganic bone component, which has been an excellent delivery medium for drugs [94,95]. BPs are constantly combined with a substrate of CaP or HA coating, to form a bio-functional coating which possesses the ability to promote new bone formation and osseointegration with the host tissue (Fig. 5A) [96]. ...
Bisphosphonates (BPs), the stable analogs of pyrophosphate, are well-known inhibitors of osteoclastogenesis to prevent osteoporotic bone loss and improve implant osseointegration in patients suffering from osteoporosis. Compared to systemic administration, BPs-incorporated coatings enable the direct delivery of BPs to the local area, which will precisely enhance osseointegration and bone repair without the systemic side effects. However, an elaborate and comprehensive review of BP coatings of implants is lacking. Herein, the cellular level (e.g., osteoclasts, osteocytes, osteoblasts, osteoclast precursors, and bone mesenchymal stem cells) and molecular biological regulatory mechanism of BPs in regulating bone homeostasis are overviewed systematically. Moreover, the currently available methods (e.g., chemical reaction, porous carriers, and organic material films) of BP coatings construction are outlined and summarized in detail. As one of the key directions, the latest advances of BP-coated implants to enhance bone repair and osseointegration in basic experiments and clinical trials are presented and critically evaluated. Finally, the challenges and prospects of BP coatings are also purposed, and it will open a new chapter in clinical translation for BP-coated implants.
... For example, the coating of calcium phosphates and hydroxyapatite (HA) like biomaterials enhance surface bioactivity and improve osseointegration [5]. Similarly, the coating of implants with various pharmacological agents like bisphosphonates, antibiotics, antimicrobial peptides, and biomolecules has been reported with promising outcomes in terms of surface properties and therapeutic effects [6]. However, to achieve beneficial therapeutic effects like reduced bacterial activity, and enhanced osteoblastic activity, the controlled and prolonged release of therapeutic agents is desired. ...
... Thus, the surface coating should sustain the shear forces during the implant insertion inside the bone. The major limitations of the coating methods are descaling, delamination, or debonding during the implant insertions and therapeutic agents cannot be delivered at a sustained rate [6]. ...
Faster and predictable osseointegration is crucial for the success of dental implants, especially in patients with compromised local or systemic conditions. Despite various surface modifications on the commercially available Titanium (Ti) dental implants, the bioactivity of Ti is still low. Thus, to achieve both biological and therapeutic activity on titanium surfaces, surface modification techniques such as titanium nanotubes have been studied as nanotube surfaces can hold therapeutic drugs and molecules. The main aim of the present research work is to study the early osseointegration around the novel Simvastatin drug eluting nanotubular dental implant. In the present research, the titanium nanotubes were fabricated on the screw-shaped dental implant surface and the Simvastatin drug was loaded into the nanotubes using the ultrasonication dip method. In vitro and In vivo studies were carried out on the modified dental implants. In vitro cell culture study reported enhanced osteogenic activity on the drug-loaded nanotube surface implants. The invivo animal studies were evaluated by micro-CT, histopathology, and reverse torque removal analysis methods. The test results showed faster osseointegration with the strong interface on the Simvastatin drug-loaded implant surface at 4 weeks of healing as compared to the control implants.
... A coat of titanium dioxide (TiO 2 ) nanotubes and GL13K showed antibacterial response against F. nucleatum and P. gingivalis and biocompatibility with preosteoblast and macrophage cells [135]. Release-killing coatings are usually based on drug delivery systems [136] and ion-releasing coatings such as Ag, Au, Zn, and Cu [137]. Antimicrobial coatings offer several advantages over the administration of antibiotics, especially in terms of their localized activity [138]. ...
Smart biomaterials can sense and react to physiological or external environmental stimuli (e.g., mechanical, chemical, electrical, or magnetic signals). The last decades have seen exponential growth in the use and development of smart dental biomaterials for antimicrobial applications in dentistry. These biomaterial systems offer improved efficacy and controllable bio-functionalities to prevent infections and extend the longevity of dental devices. This review article presents the current state-of-the-art of design, evaluation, advantages, and limitations of bioactive and stimuli-responsive and autonomous dental materials for antimicrobial applications. First, the importance and classification of smart biomaterials are discussed. Second, the categories of bioresponsive antibacterial dental materials are systematically itemized based on different stimuli, including pH, enzymes, light, magnetic field, and vibrations. For each category, their antimicrobial mechanism, applications, and examples are discussed. Finally, we examined the limitations and obstacles required to develop clinically relevant applications of these appealing technologies.
