Decontamination methods to restore the biocompatibility of contaminated titanium surfaces

PURPOSE: The reaction of cells to a titanium implant depends on the surface characteristics of the implant which are affected by decontamination. The aim of this study was to evaluate the cytocompatibility of titanium disks treated with various decontamination methods, using salivary bacterial contamination with dental pellicle formation as an in vitro model. METHODS: Sand-blasted and acid-etched (SA) titanium disks were used. Three control groups (pristine SA disks [SA group]; salivary pellicle-coated SA disks [pellicle group]; and biofilm-coated, untreated SA disks [NT group]) were not subjected to any decontamination treatments. Decontamination of the biofilm-coated disks was performed by 14 methods, including ultrasonic instruments, rotating instruments, an air-powder abrasive system, a laser, and chemical agents. MG63 cells were cultured in the presence of the treated disks. Cell proliferation assays were performed on days 2 and 5 of cell culture, and cell morphology was analyzed by immunofluorescence and scanning electron microscopy (SEM). A vascular endothelial growth factor (VEGF) assay was performed on day 5 of culture. RESULTS: The cell proliferation assay revealed that all decontaminated disks, except for the 2 groups treated using a plastic tip, showed significantly less cell proliferation than the SA group. The immunofluorescence and SEM analyses revealed that most groups showed comparable cell density, with the exception of the NT group, in which the cell density was lower and bacterial residue was observed. Furthermore, the cells grown with tetracycline-treated titanium disks showed significantly lower VEGF production than those in the SA group. CONCLUSIONS: None of the decontamination methods resulted in cytocompatibility similar to that of pristine SA titanium. However, many methods caused improvement in the biocompatibility of the titanium disks in comparison with the biofilm-coated, untreated titanium disks. This suggests that decontamination is indispensable for the treatment of peri-implantitis, even if the original biocompatibility cannot be restored.

The thickness of alveolar bone at the maxillary canine and premolar teeth in normal occlusion

PURPOSE: The main purpose of this study was to investigate bone thickness on the buccal and palatal aspects of the maxillary canine and premolars using cone-beam computed tomography (CBCT). The differences between left- and right-side measurements and between males and females were also analyzed. METHODS: The sample consisted of 20 subjects (9 males and 11 females; mean age, 21.9+/-3.0) selected from the normal occlusion sample data in the Department of Orthodontics, The Catholic University of Korea. The thickness of the buccal and palatal bone walls, perpendicular to the long axis of the root were evaluated at 3 mm and 5 mm apical to cemento-enamel junction (CEJ) and at root apex. RESULTS: At the canines and first premolars regions, mean buccal bone thickness of at 3 mm and 5 mm apical to CEJ were less than 2 mm. In contrast, at the second premolar region, mean buccal bone thickness at 3 mm and 5 mm apical from CEJ were greater than 2 mm. Frequency of thick bone wall (> or =2 mm) increased from the canine to the second premolar. CONCLUSIONS: This result should be considered before tooth extraction and planning of rehabilitation in the canine and premolar area of maxilla. Careful preoperative analysis with CBCT may be beneficial to assess local risk factors and to achieve high predictability of success in implant therapy.