Biomimetic coatings enhance tribocorrosion behavior and cell responses of commercially pure titanium surfaces.

Biofunctionalized surfaces for implants are currently receiving much attention in the health care sector. Our aims were (1) to create bioactive Ti-coatings doped with Ca, P, Si, and Ag produced by microarc oxidation (MAO) to improve the surface properties of biomedical implants, (2) to investigate the TiO2 layer stability under wear and corrosion, and (3) to evaluate human mesenchymal stem cells (hMSCs) responses cultured on the modified surfaces. Tribocorrosion and cell experiments were performed following the MAO treatment. Samples were divided as a function of different Ca/P concentrations and treatment duration. Higher Ca concentration produced larger porous and harder coatings compared to the untreated group (p < 0.001), due to the presence of rutile structure. Free potentials experiments showed lower drops (-0.6 V) and higher coating lifetime during sliding for higher Ca concentration, whereas lower concentrations presented similar drops (-0.8 V) compared to an untreated group wherein the drop occurred immediately after the sliding started. MAO-treated surfaces improved the matrix formation and osteogenic gene expression levels of hMSCs. Higher Ca/P ratios and the addition of Ag nanoparticles into the oxide layer presented better surface properties, tribocorrosive behavior, and cell responses. MAO is a promising technique to enhance the biological, chemical, and mechanical properties of dental implant surfaces.

The effect of casting and masticatory simulation on strain and misfit of implant-supported metal frameworks.

The influence of casting and masticatory simulation on marginal misfit and strain in multiple implant-supported prostheses was evaluated. Three-unit screw retained fixed dental prosthesis (FDP) and screw retained full-arch fixed dental prosthesis (FAFDP) frameworks were made using calcinable or overcasted cylinders on conical dental implant abutment. Four groups were obtained according to the cylinder and prosthesis type (n=10). Frameworks were casted in CoCr alloy and subjected to strain gauge analyses and marginal misfit measurements before and after 10(6) mechanical cycles (2 Hz/280 N). Results were submitted to ANOVA, Tukey's HSD and Pearson correlation test (α=0.05). No difference was found on misfit among all groups and times (p>0.05). Overcasted frameworks showed higher strain than the calcinable ones (FDP - Initial p=0.0047; Final p=0.0004; FAFDP - Initial p=0.0476; Final p=0.0115). The masticatory simulation did not influence strain (p>0.05). No correlation was observed between strain and misfit (r=0.24; p>0.05). In conclusion, the marginal misfit value in the overcasted full-arch frameworks was higher than clinical acceptable data. It proved that overcasted method is not an ideal method for full-arch prosthesis. Overcasted frameworks generate higher strain upon the system. The masticatory simulation had no influence on misfit and strain of multiple prostheses.

Production of a biofunctional titanium surface using plasma electrolytic oxidation and glow-discharge plasma for biomedical applications.

In this study, the authors tested the hypotheses that plasma electrolytic oxidation (PEO) and glow-discharge plasma (GDP) would improve the electrochemical, physical, chemical, and mechanical properties of commercially pure titanium (cpTi), and that blood protein adsorption on plasma-treated surfaces would increase. Machined and sandblasted surfaces were used as controls. Standard electrochemical tests were conducted in artificial saliva (pHs of 3.0, 6.5, and 9.0) and simulated body fluid. Surfaces were characterized by scanning electron microscopy, energy-dispersive spectroscopy, x-ray photoelectron spectroscopy, atomic force microscopy, x-ray diffraction, profilometry, Vickers microhardness, and surface energy. For biological assay, the adsorption of blood serum proteins (i.e., albumin, fibrinogen, and fibronectin) was tested. Higher values of polarization resistance and lower values of capacitance were noted for the PEO and GDP groups (p < 0.05). Acidic artificial saliva reduced the corrosion resistance of cpTi (p < 0.05). PEO and GDP treatments improved the surface properties by enrichment of the surface chemistry with bioactive elements and increased surface energy. PEO produced a porous oxide layer (5-µm thickness), while GDP created a very thin oxide layer (0.76-µm thickness). For the PEO group, the authors noted rutile and anatase crystalline structures that may be responsible for the corrosion barrier improvement and increased microhardness values. Plasma treatments were able to enhance the surface properties and electrochemical stability of titanium, while increasing protein adsorption levels.

Tribocorrosion behavior of biofunctional titanium oxide films produced by micro-arc oxidation: Synergism and mechanisms.

Dental implants, inserted into the oral cavity, are subjected to a synergistic interaction of wear and corrosion (tribocorrosion), which may lead to implant failures. The objective of this study was to investigate the tribocorrosion behavior of Ti oxide films produced by micro-arc oxidation (MAO) under oral environment simulation. MAO was conducted under different conditions as electrolyte composition: Ca/P (0.3M/0.02M or 0.1M/0.03M) incorporated with/without Ag (0.62g/L) or Si (0.04M); and treatment duration (5 and 10min). Non-coated and sandblasted samples were used as controls. The surfaces morphology, topography and chemical composition were assessed to understand surface properties. ANOVA and Tukey׳s HSD tests were used (α=0.05). Biofunctional porous oxide layers were obtained. Higher Ca/P produced larger porous and harder coatings when compared to non-coated group (p<0.001), due to the presence of rutile crystalline structure. The total mass loss (Kwc), which includes mass loss due to wear (Kw) and that due to corrosion (Kc) were determined. The dominant wear regime was found for higher Ca/P groups (Kc/Kw≈0.05) and a mechanism of wear-corrosion for controls and lower Ca/P groups (Kc/Kw≈0.11). The group treated for 10min and enriched with Ag presented the lowest Kwc (p<0.05). Overall, MAO process was able to produce biofunctional oxide films with improved surface features, working as tribocorrosion resistant surfaces.

Fit and Stability of Screw-Retained Implant-Supported Frameworks Under Masticatory Simulation: Influence of Cylinder Type.

PURPOSE: The aim of the study was to evaluate the effect of a prosthetic cylinder and casting on the misfit and loosening torque of screw-retained multiple-unit implant-supported dental prostheses under masticatory simulation. MATERIALS AND METHODS: Screw-retained, three-unit fixed dental prostheses (FDP) and screw-retained full-arch FDP frameworks were waxed using calcinable (plastic cylinders) or overcasted (premachined cast-on cylinders) on the dental implant abutments. The cylinders were cast in Co-Cr alloy to obtain four groups according to cylinder type and prosthesis type (n = 10). The screws were tightened with 20 N/cm (abutment) and 10 N/cm (prosthetic) torque according to the manufacturer's recommendation. After 24 hours, the initial loosening torque was analyzed. The initial misfit measurements were performed according to the Schiffleger test. The screws were retightened, and the specimens were submitted to 10(6) mechanical cycles (2 Hz/280 N). Loosening torque and misfit were reevaluated (final measurements), and data were submitted to ANOVA, Tukey's HSD, and Pearson's correlation tests (α = 0.05). RESULTS: The calcinable three-unit FDP demonstrated greater misfit (initial: 107.53 ± 40.36 µm; final: 99.00 ± 40.85 µm) than did the overcasted three-unit FDP frameworks (initial: 51.50 ± 22.98 µm; final: 44.33 ± 14.14 µm) (initial: p = 0.0005; final: p = 0.0007). No difference was noted between the calcinable and overcasted full-arch FDP frameworks (p > 0.05). Masticatory simulation did not affect the misfit (p > 0.05). The overcasted full-arch FDP presented a lower abutment screw loosening torque (12.05 ± 1.80 N/cm) than did the calcinable ones (14.75 ± 1.72 N/cm) in the final measurement (p = 0.0024). The calcinable groups presented a lower prosthetic screw loosening torque than did the overcasted groups in the final evaluation (p < 0.05). After masticatory simulation, the prosthetic screw loosening torque of the calcinable three-unit FDP decreased (initial: 5.49 ± 1.07 N/cm; final: 3.73 ± 1.15 N/cm; p = 0.0044). Correlation between misfit and loosening was observed only for the prosthetic screws (p < 0.05). CONCLUSIONS: The overcasted components provided a better fit in three-unit FDPs but did not influence the fit of full-arch FDPs. Prosthetic screws of overcasted frameworks presented higher stability, whereas masticatory simulation did not influence misfit but did reduce the prosthetic screw loosening torque of calcinable three-unit FDP frameworks.

Incorporation of Ca, P, and Si on bioactive coatings produced by plasma electrolytic oxidation: The role of electrolyte concentration and treatment duration.

The objectives of the present study were to produce bioactive coatings in solutions containing Ca, P, and Si by plasma electrolytic oxidation (PEO) on commercially pure titanium, to investigate the influence of different electrolytes concentration and treatment duration on the produced anodic films and to evaluate biocompatibility properties. The anodic films were characterized using scanning electron microscopy, energy-dispersive spectroscopy, atomic force microscopy, and x-ray diffraction and x-ray photoelectron spectroscopies. The surface energy and roughness were also evaluated. PEO process parameters influenced the crystalline structure formation and surface topography of the anodic films. Higher Ca content produced larger porous (volcanolike appearance) and thicker oxide layers when compared to the lower content. Treatment duration did not produce any topography difference. The treatment modified the surface chemistry, producing an enriched oxide layer with bioactive elements in the form of phosphate compounds, which may be responsible for mimicking bone surface. In addition, a rough surface with increased surface energy was generated. Optimal spreading and proliferation of human mesenchymal stem cells was achieved by PEO treatment, demonstrating excellent biocompatibility of the surface. The main finding is that the biofunctionalization with higher Ca/P on Ti-surface can improve surface features, potentially considered as a candidate for dental implants.

Electrochemical behavior of bioactive coatings on cp-Ti surface for dental application.

The surface characteristics and electrochemical properties of bioactive coatings produced by plasma electrolytic oxidation (PEO) with calcium, phosphorous, silicon and silver on commercially pure titanium were evaluated. PEO treatment produced a porous oxide layer, which improved the surface topography, and enriched the surface chemistry with bioactive elements, responsible for mimicking bone surface. The surfaces with higher calcium concentration presented antibacterial and biocompability properties with better responses for corrosion and barrier properties, due to the presence of rutile crystalline structure. PEO may be a promising surface treatment option to improve the electrochemical behavior of dental implants mitigating treatment failures.

Archwire cleaning after intraoral ageing: the effects on debris, roughness, and friction.

Dental material science has paid more attention to mechanical properties of as-received materials than to changes produced after intraoral exposure. Orthodontic archwires when exposed to the intraoral environment have shown a significant increase in the degree of debris, surface roughness (Ra), and frictional force. The purpose of this split-mouth study was to evaluate the effects of two methods of archwire cleaning on these variables after clinical use for 8 weeks. For eight individuals, four sets of three brackets each (n = 32) were bonded from the first molar to the first premolar. A passive segment of 0.019 × 0.025 inch stainless steel (SS) archwire was inserted into the brackets and tied by elastomeric ligature. Debris level [via scanning electron microscopy (SEM)], Ra, and frictional force were evaluated in a paired comparison after 8 weeks of intraoral exposure and after cleaning with a steel wool sponge (SWS) for 1 minute or ultrasound (US) cleaning for 15 minutes. Kruskal-Wallis, Friedman's, and Spearman and Pearson correlation tests were used for statistical analysis. The debris and Ra of SS rectangular wires increased significantly (P < 0.05) during clinical use, causing a significant increase in the frictional force level. These changes can be effectively eliminated by either of the investigated cleaning methods, although a SWS seems to be clinically more practical.

Recurrent Infection by varicella-zoster virus with facial scarring / Infecção recorrente pelo vírus varicela-zoster com sequelas cicatriciais na face

Primary contact with the varicella-zoster virus occurs through varicella (chickenpox) and culminates with this virus entering the sensory nerves and remaining latent in the dorsal root ganglion. Transmission occurs by dissemination of infectious particles of the varicella-zoster virus by the aerosol released from nasopharyngeal secretions or skin lesions, or by direct contact with lesions. Herpes zoster occurs after clinically evident reactivation of the virus, affecting the whole distribution of the infected sensory nerve. When compared with primary infection, herpes zoster has a more severe character, requiring the use of pharmaceutical drugs. The cause of reactivation is unknown and may be associated with predisposing factors, such as age, stress or impaired immune system. This study reports a case of a patient who presented clinical manifestations compatible with varicella zoster infection exacerbated by the use of homemade remedies, resulting in a secondary infection and facial scarring.

O contato primário com o vírus varicela-zoster ocorre na varicela (catapora), culminando com a transposição desse vírus para os nervos sensitivos, onde estabelece sua latência no gânglio espinhal dorsal. A transmissão ocorre por disseminação das partículas infecciosas do vírus varicela-zoster através de aerossóis liberados a partir de secreções do nasofaringe ou lesões cutâneas ou, ainda, pelo contato direto com lesões. O herpes-zoster clinicamente evidente ocorre após a reativação do vírus, com o envolvimento da distribuição do nervo sensitivo afetado. Quando comparado com a infecção primária, o herpes-zoster desenvolve um caráter de maior severidade, sendo sempre necessária a administração de uma terapêutica medicamentosa eficaz. A causa dessa reativação é desconhecida, podendo estar relacionada a fatores predisponentes como a faixa etária, estresse ou imunodeficiências. Neste trabalho relata-se um caso clínico em que a paciente apresentou manifestações clínicas condizentes com um quadro característico de infecção por varicela-zoster, complicado por uso de medicação caseira, resultando em infecção secundária e cicatrizes faciais.