Effects of calcium phosphate/chitosan composite on bone healing in rats: calcium phosphate induces osteon formation.

Vascularization of an artificial graft represents one of the most significant challenges facing the field of bone tissue engineering. Over the past decade, strategies to vascularize artificial scaffolds have been intensively evaluated using osteoinductive calcium phosphate (CaP) biomaterials in animal models. In this work, we observed that CaP-based biomaterials implanted into rat calvarial defects showed remarkably accelerated formation and mineralization of new woven bone in defects in the initial stages, at a rate of ∼60 µm/day (0.8 mg/day), which was considerably higher than normal bone growth rates (several µm/day, 0.1 mg/day) in implant-free controls of the same age. Surprisingly, we also observed histological evidence of primary osteon formation, indicated by blood vessels in early-region fibrous tissue, which was encapsulated by lamellar osteocyte structures. These were later fully replaced by compact bone, indicating complete regeneration of calvarial bone. Thus, the CaP biomaterial used here is not only osteoinductive, but vasculogenic, and it may have contributed to the bone regeneration, despite an absence of osteons in normal rat calvaria. Further investigation will involve how this strategy can regulate formation of vascularized cortical bone such as by control of degradation rate, and use of models of long, dense bones, to more closely approximate repair of human cortical bone.

Caracterización metalográfica de barras para sobredentaduras, elaboradas por sobrecolado de pilares para implantes dentales / Metallographic characterization of overdenture bars manufactured by overcasting abutments for dental implants

Introducción: la dificultad en el manejo de prótesis totales convencionales en pacientes totalmente edéntulos puede ser mejorada con el uso de sistemas de anclaje sobre implantes dentales para sobredentaduras. El objetivo fue caracterizar metalográficamente un sistema de barras para sobredentadura por sobrecolado de una aleación de metal base, sobre pilares prefabricados en aleación de titanio. Métodos: mediante un diseño de barras para sobredentaduras, elaboradas con un aditamento de titanio (Ti-6Al-4V) prefabricado y una aleación de metal base (Ni65%-Cr22,5%-Mo9,5%). Se hace caracterización metalográfica del proceso de sobrecolado, analizando la influencia en la microestructura de las aleaciones dentales comerciales Ti-6Al-4V y Ni65%-Cr22,5%-Mo9,5% (Wiron 99) mediante microscopía electrónica de barrido (SEM), microanálisis por técnica de espectrometría de energías dispersivas de rayos X (EDS), análisis mediante microscopía óptica (MO) y estereomicroscopía (EM). Resultados: se encontró que durante el proceso de sobrecolado, se produce una unión química con presencia de oxígenos entre estas 2 aleaciones; evidenciando estructuras dendríticas heterogéneas a lo largo de las muestras debido a la irregularidad en el espesor de las barras utilizadas y los precipitados en sus fronteras de Mo. Conclusiones: la unión química de las 2 aleaciones de Ni65%-Cr22,5%-Mo9,5%y Ti-6Al-4V después del proceso de sobrecolado, permite considerar desde el punto de vista metalográfico, el sobrecolado entre estas dos aleaciones como una opción viable para la realización de estructuras sobre pilares de implantes.

Introduction: the difficulty in handling conventional dentures in fully edentulous patients may be improved by using anchorage systems on dental implants for overdentures. The goal of this study was to conduct a metallographic characterization of a system of bars for overdentures by overcasting a metal base alloy on prefabricated titanium alloy abutments. Methods: using a design of overdenture bars, made with an addition of prefabricated titanium (Ti-6Al-4V) and a metal base alloy (Ni65-Cr22%,5%-Mo9,5%), a metallographic characterization of the overcasting process was performed by analyzing its influence on the microstructure of two commercial dental alloys: Ti-6Al-4V and Ni65%-Cr22,5%-Mo9,5% (Wiron 99) using scanning electron microscopy (SEM), energy dispersive X-ray spectrometry (EDS), light microscopy analysis (LM), and stereomicroscopy (EM). Results: the findings suggest that during overcasting a chemical bonding occurs due to the presence of oxygen between these two alloys, showing heterogeneous dendritic structures along the samples due to thickness irregularities on the bars and to precipitations of their molybdenum borders. Conclusions: from a metallographic perspective, the chemical bonding of the two alloys (Ni65-Cr22%, 5%-Mo9, 5% and Ti-6Al-4V) after overcasting suggests that overcasting between these two alloys is a viable option for placing structures on implant abutments.

[Enteric Gram negative rods and unfermented of glucose bacteria in patients with peri-implant disease]. / Bacilos Gram negativos entéricos y no fermentadores de la glucosa en pacientes con enfermedad periimplante.

INTRODUCTION: Implants can be colonized by microorganisms from oral biofilms and may affect peri-implant tissues health. Among these bacteria, pathogens typically associated with periodontitis can be found, such as Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis, as well as Gram negative enteric bacilli not typically associated with periodontal diseases. OBJECTIVE: Superinfecting bacteria were characterized from peri-implant lesions in patients with history of periodontitis. MATERIALS AND METHODS: Sixty-eight implants were studied in 55 patients; the average patient age was 56 years. Forty-nine implants had peri-implant lesions and 19 were considered stable. Subgingival samples were obtained in affected and stable implants. The samples were streaked on Mac-Conkey agar and incubated at 37°C for 24 hours. The colonies were identified with the kit-BD BBL Crystal E/NF®. RESULTS: Superinfecting organisms were detected in 20 patients--they were seen more frequently at diseased implants (n=15) than at healthy implants (n=5). The prevalence of superinfecting bacteria on the selected implants was 33.8% (n=23/68). These bacteria were more prevalent among affected implants (n=17 or 25%) than those with stable implants n=6 (8.8%). Klebsiella pneumoniae was the most frequent Gram negative rod detected (n=12). CONCLUSIONS: One-third of the implants had superinfecting organisms. Implants with a peri-implant lesion had a higher frequency of superinfecting bacteria. Klebsiella pneumoniae was the most common superinfecting organism isolated. A multiple infection caused by superinfecting bacteria was present only at diseased implants. These microbial agents potentially affect implant stability.

Bacilos Gram negativos entéricos y no fermentadores de la glucosa en pacientes con enfermedad periimplante / Enteric Gram negative rods and unfermented of glucose bacteria in patients with peri-implant disease

Introducción. Los implantes pueden ser colonizados por microorganismos de la biopelícula oral y así afectarse su salud. Entre los patógenos encontrados están los típicamente relacionados con periodontitis, como Aggregatibacter actinomycetemcomitans y Porphyromonas gingivalis, así como bacilos Gram negativos entéricos, los cuales no son clásicos de la enfermedad periodontal. Objetivo. Determinar el perfil de las bacterias sobreinfecciosas en lesiones periimplante (mucositis o periimplantitis), en pacientes con historia de periodontitis. Materiales y métodos. Se estudiaron 68 implantes en 55 pacientes; 49 implantes tuvieron lesión periimplante19 se consideraron estables. Se obtuvieron muestras subgingivales de implantes afectados y estables; éstas fueron sembradas en Agar MacConkey e incubadas a 37 °C por 24 horas. Las colonias aisladas fueron identificadas con el estuche BD BBL-Cristal E/NF®. Resultados. En 20 de los pacientes estudiados se detectaron bacterias sobreinfecciosas, pero, con mayor frecuencia en pacientes con implantes afectados (n=15) que en portadores de implantes sanos (n=5). La prevalencia de bacterias sobreinfecciosas en todos los implantes fue de 33,8 % (n=23/68), y también fue más frecuente su aislamiento en implantes afectados (n=17) (25%), que en estables (n=6) (8,8%). Klebsiella pneumoniae fue el microorganismo que se aisló con mayor frecuencia en todos los implantes (n=12). Conclusiones. Un tercio de los implantes estudiados presentaron organismos sobreinfecciosos. Los implantes con lesiones periimplante presentan una mayor frecuencia de bacterias sobreinfecciosas. K. pneumoniae es la especie sobreinfecciosa más frecuente en los implantes estudiados. Se presentó infección múltiple con dichas bacterias en los implantes afectados. Estos microorganismos pueden afectar la estabilidad de los implantes.

Introduction. Implants can be colonized by microorganisms from oral biofilms and may affect peri-implant tissues health. Among these bacteria, pathogens typically associated with periodontitis can be found, such as Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis, as well as Gram negative enteric bacilli not typically associated with periodontal diseases. Objective. Superinfecting bacteria were characterized from peri-implant lesions in patients with history of periodontitis. Materials and methods. Sixty-eight implants were studied in 55 patients; the average patient age was 56 years. Forty-nine implants had peri-implant lesions and 19 were considered stable. Subgingival samples were obtained in affected and stable implants. The samples were streaked on Mac-Conkey agar and incubated at 37°C for 24 hours. The colonies were identified with the kit-BD BBL Crystal E/NF®. Results. Superinfecting organisms were detected in 20 patients--they were seen more frequently at diseased implants (n=15) than at healthy implants (n=5). The prevalence of superinfecting bacteria on the selected implants was 33.8% (n=23/68). These bacteria were more prevalent among affected implants (n=17 or 25%) than those with stable implants n=6 (8.8%). Klebsiella pneumoniae was the most frequent Gram negative rod detected (n=12). Conclusions. One-third of the implants had superinfecting organisms. Implants with a peri-implant lesion had a higher frequency of superinfecting bacteria. Klebsiella pneumoniae was the most common superinfecting organism isolated. A multiple infection caused by superinfecting bacteria was present only at diseased implants. These microbial agents potentially affect implant stability.

Subgingival microbiota in peri-implant mucosa lesions and adjacent teeth in partially edentulous patients.

BACKGROUND: Osseointegrated dental implants have been shown to be a predictable approach to provide the adequate support for the replacement of missing teeth. It has been observed that implants showing signs of peri-implantitis contain subgingival microbiota similar to that around natural teeth with periodontal disease. This study identified the subgingival microbiota around implants with peri-implant lesions and natural teeth in partially edentulous patients. METHODS: Clinical and radiographic parameters were recorded and microbial samples taken from 16 implants with signs of pocketing, 12 neighboring and 11 non-neighboring teeth to the affected implants in 11 patients and 15 stable implants in eight patients (controls). Samples were cultured using techniques for Enterobacteriaceae spp and facultative/anaerobic periodontal pathogens. Statistical analysis included Friedman test to establish differences between the subgingival microbiota cultured from implants and teeth and two-tailed Mann Whitney test and chi square to find differences in two separate samples (P < or = 0.05). RESULTS: There were statistical differences between the subgingival microbiota in peri-implant lesions and stable implants for Gram-negative enteric rods (P <0.05). P. gingivalis (1.42%) was detected in peri-implant lesions but not in stable implants. A significant correlation between the subgingival microbiota from implants and neighboring teeth for Gram-negative enteric rods (P = 0.023) and implants and non-neighboring teeth for P. gingivalis (P = 0.042) was found. The frequency detection of Gram-negative enteric rods (75%) and P. intermedia/nigrescens (25%) was higher in peri-implant lesions (P <0.05). CONCLUSIONS: The subgingival microbiota in peri-implant lesions showed high levels of periodontopathic bacteria and superinfecting bacteria compared to healthy stable implants. The role of superinfecting bacteria in the pathogenesis of peri-implant lesions needs further investigation.