Bone-to-Implant Contact in Implants with Plasma-Treated Nanostructured Calcium-Incorporated Surface (XPEEDActive) Compared to Non-Plasma-Treated Implants (XPEED): A Human Histologic Study at 4 Weeks.

Titanium implants undergo an aging process through surface hydrocarbon deposition, resulting in decreased wettability and bioactivity. Plasma treatment was shown to significantly reduce surface hydrocarbons, thus improving implant hydrophilicity and enhancing the osseointegration process. This study investigates the effect of plasma surface treatment on bone-to-implant contact (BIC) of implants presenting a nanostructured calcium-incorporated surface (XPEED®). Following a Randomized Controlled Trial (RCT) design, patients undergoing implant surgery in the posterior maxilla received additional plasma-treated (n = 7) or -untreated (n = 5) 3.5 × 8 mm implants that were retrieved after a 4-week healing period for histological examination. Histomorphometric analysis showed that plasma-treated implants exhibited a 38.7% BIC rate compared to 22.4% of untreated implants (p = 0.002), indicating enhanced osseointegration potential. Histological images also revealed increased bone formation and active osteoblastic activity around plasma-treated implants when compared to untreated specimens. The findings suggest that plasma treatment improves surface hydrophilicity and biological response, facilitating early bone formation around titanium implants. This study underscores the importance of surface modifications in optimizing implant integration and supports the use of plasma treatment to enhance osseointegration, thereby improving clinical outcomes in implant dentistry and offering benefits for immediate and early loading protocols, particularly in soft bone conditions.

Nanostructured Calcium-Incorporated Surface Compared to Machined and SLA Dental Implants-A Split-Mouth Randomized Case/Double-Control Histological Human Study.

Background: Implant surface topography is a key element in achieving osseointegration. Nanostructured surfaces have shown promising results in accelerating and improving bone healing around dental implants. The main objective of the present clinical and histological study is to compare, at 4 and 6 weeks, (w) bone-to-implant contact in implants having either machined surface (MAC), sandblasted, large grit, acid-etched implant surface (SLA) medium roughness surface or a nanostructured calcium-incorporated surface (XPEED®). Methods: 35 mini-implants of 3.5 × 8.5 mm with three different surface treatments (XPEED® (n = 16)­SLA (n = 13)­MAC (n = 6), were placed in the posterior maxilla of 11 patients (6 females and 5 males) then, retrieved at either 4 or 6w in a randomized split-mouth study design. Results: The BIC rates measured at 4w and 6w respectively, were: 16.8% (±5.0) and 29.0% (±3.1) for MAC surface; 18.5% (±2.3) and 33.7% (±3.3) for SLA surface; 22.4% (±1.3) and 38.6% (±3.2) for XPEED® surface. In all types of investigated surfaces, the time factor appeared to significantly increase the bone to implant contact (BIC) rate (p < 0.05). XPEED® surface showed significantly higher BIC values when compared to both SLA and MAC values at 4w (p < 0.05). Also, at 6w, both roughened surfaces (SLA and XPEED®) showed significantly higher values (p < 0.05) than turned surface (MAC). Conclusions: Nanostructured Calcium titanate coating is able to enhance bone deposition around implants at early healing stages.

Preliminary Study with the Use of a Titanium Mesh as Space Maker and Implant Primary Stabilization for One-Stage Sinus Lift in Cases with Less Than 1.5 mm Residual Bone.

(1) Background: In the lateral area of the maxilla, the alveolar bone can lose significant volume due to maxillary sinus pneumatization following teeth extractions. This preliminary study evaluated the effectiveness of a novel technique for one-stage sinus lifting and simultaneous implant placement in cases with less than 1.5 mm residual alveolar bone. The subsequent survival rate at 1-year post-occlusal loading was assessed. (2) Methods: 15 patients were selected, the main inclusion criteria were the partially edentulous area in the posterior maxilla with alveolar bone height of less than 1.5 mm below the sinus. All of the patients underwent one-stage sinus lifting, along with simultaneous implant placement using a "butterfly" anchorage device to optimize the primary stability and xenograft bone as graft material. At 6 to 9 months after surgery, the anchorage device was removed and implants were loaded. Panoramic x-ray images were used to assess the new bone formation, while the biological stability was measured using resonance frequency analysis. (3) Results: 15 implants were inserted. The mean implant stability quotient (ISQ) value was 71.3 (SD = ±2.51) and the mean healing period was 7.3 (SD = ±1.23) months. The mean bone height after the healing period was 14.4 (SD = ±2.05). A statistically significant correlation was found between the healing period and the ISQ value (Spearman rho = 0.684, sig. = 0.005). No statistically significant correlation was found between the ISQ value and the new regenerated bone height (Person r = 0.389, sig. = 0.152). Smoking was identified as a risk factor involved in postoperative complications. (4) Conclusions: The results of the present preliminary study demonstrated that the proposed "butterfly" technique was effective when performing one-stage sinus lifting and simultaneous implant placement in cases with less than 1.5 mm of residual alveolar bone. The survival rate was 100% at 1-year post occlusal loading.

Primary Stability Optimization by Using Fixtures with Different Thread Depth According To Bone Density: A Clinical Prospective Study on Early Loaded Implants.

Background: Macro- and micro-geometry are among the factors influencing implant stability and potentially determining loading protocol. The purpose of this study was to test a protocol for early loading by controlling implant stability with the selection of fixtures with different thread depth according to the bone density of the implant site. Materials and Methods: Patients needing implant therapy for fixed prosthetic rehabilitation were treated by inserting fixtures with four different thread diameters, selected based on clinical assessment of bone quality at placement (D1, D2, D3, and D4, according to Misch classification). Final insertion torque (IT) and implant stability quotient (ISQ) were recorded at baseline and ISQ measurements repeated after one, two, three, and four weeks. At the three-week measurement (four weeks after implant replacement), implants with ISQ > 70 Ncm were functionally loaded with provisional restorations. Marginal bone level was radiographically measured 12 months after implant insertion. Results: Fourteen patients were treated with the insertion of forty implants: Among them, 39 implants showing ISQ > 70 after 3 weeks of healing were loaded with provisional restoration. Mean IT value was 82.3 ± 33.2 Ncm and varied between the four different types of bone (107.2 ± 35.6 Ncm, 74.7 ± 14.0 Ncm, 76.5 ± 31.1 Ncm, and 55.2 ± 22.6 Ncm in D1, D2, D3, and D4 bone, respectively). Results showed significant differences except between D2 and D3 bone types. Mean ISQ at baseline was 79.3 ± 4.3 and values in D1, D2, D3, and D4 bone were 81.9 ± 2.0, 81.1 ± 1.0, 78.3 ± 3.7, and 73.2 ± 4.9, respectively. Results showed significant differences except between D1 and D2 bone types. IT and ISQ showed a significant positive correlation when analyzing the entire sample (p = 0.0002) and D4 bone type (p = 0.0008). The correlation between IT and ISQ was not significant when considering D1, D2, and D3 types (p = 0.28; p = 0.31; p = 0.16, respectively). ISQ values showed a slight drop at three weeks for D1, D2, and D3 bone while remaining almost unchanged in D4 bone. At 12-month follow-up, all implants (39 early loading, 1 conventional loading) had satisfactory function, showing an average marginal bone loss of 0.12 ± 0.12 mm, when compared to baseline levels. Conclusion: Matching implant macro-geometry to bone density can lead to adequate implant stability both in hard and soft bone. High primary stability and limited implant stability loss during the first month of healing could allow the application of early loading protocols with predictable clinical outcomes.

The Modified Socket Shield Technique.

OBJECTIVE: In the anterior regions, the resorption of the buccal bone after tooth extraction leads to a contraction of the overlying soft tissues, resulting in an esthetic problem, particularly with immediate implant placement. In the socket shield technique, the buccal root section of the tooth is maintained, to preserve the buccal bone for immediate implant placement. The aim of this prospective study was to investigate the survival, stability, and complication rates of implants placed using a "modified" socket shield technique. METHODS: Over a 2-year period, all patients referred to a dental clinic for treatment with oral implants were considered for inclusion in this study. Inclusion criteria were healthy adult patients who presented nonrestorable single teeth with intact buccal periodontal tissues in the anterior regions of both jaws. Exclusion criteria were teeth with present/past periodontal disease, vertical root fractures on the buccal aspect, horizontal fractures below bone level, and external/internal resorptions. The buccal portion of the root was retained to prevent the resorption of the buccal bone; the shield was 1.5 mm thick with the most coronal portion at the bone crest level. All patients then underwent immediate implants. In the patient with a gap between the implant and shield, no graft material was placed. All implants were immediately restored with single crowns and followed for 1 year. The main outcomes were implant survival, stability, and complications. RESULTS: Thirty patients (15 males, 15 females; mean age was 48.2 ±â€Š15.0 years) were enrolled in the study and installed with 40 immediate implants. After 1 year, all implants were functioning, for a survival rate of 100%; excellent implant stability was reported (mean implant stability quotient at placement: 72.9 ±â€Š5.9; after 1 year: 74.6 ±â€Š2.7). No biologic complications were reported, and the incidence of prosthetic complications was low (2.5%). CONCLUSIONS: The "modified" socket shield technique seems to be a successful procedure when combined with immediate implant placement, because the root fragment does not interfere with osseointegration and may be beneficial for the esthetics, protecting the buccal bone from resorption.

Flexible heartbeat sensor for wearable device.

We demonstrate a flexible strain-gauge sensor and its use in a wearable application for heart rate detection. This polymer-based strain-gauge sensor was fabricated using a double-sided fabrication method with polymer and metal, i.e., polyimide and nickel-chrome. The fabrication process for this strain-gauge sensor is compatible with the conventional flexible printed circuit board (FPCB) processes facilitating its commercialization. The fabricated sensor showed a linear relation for an applied normal force of more than 930 kPa, with a minimum detectable force of 6.25Pa. This sensor can also linearly detect a bending radius from 5mm to 100mm. It is a thin, flexible, compact, and inexpensive (for mass production) heart rate detection sensor that is highly sensitive compared to the established optical photoplethysmography (PPG) sensors. It can detect not only the timing of heart pulsation, but also the amplitude or shape of the pulse signal. The proposed strain-gauge sensor can be applicable to various applications for smart devices requiring heartbeat detection.

Effects of Thread Depth in the Neck Area on Peri-Implant Hard and Soft Tissues: An Animal Study.

BACKGROUND: Implants with deep thread depth have been developed for the purpose of increasing total implant surface area. However, effects of implant thread depth remain controversial. The aim of this study is to examine effects of thread depth on peri-implant tissues in terms of bone-implant contact (BIC), bone-implant volume (BIV), and hard and soft tissue dimensions using comprehensive analyses, including microcomputed tomography (micro-CT). METHODS: Five beagle dogs received experimental intramandibular implants 3 months after removal of their premolars and first molars (P2, P3, P4, and M1). Two different types of implants were installed in each animal: deep threaded (DT) and shallow threaded (ST). Resonance frequency testing was performed on the day of implantation as well as 4 and 8 weeks after implantation. Intraoral radiography, micro-CT, and histomorphometry were used to evaluate peri-implant tissues 4 and 8 weeks after implantation. RESULTS: There were no significant differences in resonance frequency test results between the two groups. Although radiographic analysis showed no group differences, micro-CT (P = 0.01) and histomorphometry (P = 0.003) revealed the DT group had significantly lower BIC values than the ST group at 4 weeks. However, by 8 weeks, BIC values of the two groups did not differ significantly. No significant differences in BIV or soft tissue height were observed between the two groups at either time point. CONCLUSION: DT implants showed no benefits over ST implants when inserted in dog mandibles.

Immediate Loading of Tapered Implants Placed in Postextraction Sockets and Healed Sites.

OBJECTIVE: The aim of the present study was to compare the survival, stability, and complications of immediately loaded implants placed in postextraction sockets and healed sites. METHODS: Over a 2-year period, all patients presenting with partial or complete edentulism of the maxilla and/or mandible (healed site group, at least 4 months of healing after tooth extraction) or in need of replacement of nonrecoverable failing teeth (postextraction group) were considered for inclusion in this study. Tapered implants featuring a nanostructured calcium-incorporated surface were placed and loaded immediately. The prosthetic restorations comprised single crowns, fixed partial dentures, and fixed full arches. Primary outcomes were implant survival, stability, and complications. Implant stability was assessed at placement and at each follow-up evaluation (1 week, 3 months, and 1 year after placement): implants with an insertion torque (IT) <45 N·cm and/or with an implant stability quotient (ISQ) <70 were considered failed for immediate loading. A statistical analysis was performed. RESULTS: Thirty implants were placed in postextraction sockets of 17 patients, and 32 implants were placed in healed sites of 22 patients. There were no statistically significant differences in ISQ values between the 2 groups, at each assessment. In total, 60 implants (96.8%) had an IT ≥45 and an ISQ ≥70 at placement and at each follow-up control: all these implants were successfully loaded. Only 2 implants (1 in a postextraction socket and 1 in a healed site, 3.2%) could not achieve an IT ≥45 N·cm and/or an ISQ ≥70 at placement or over time: accordingly, these were considered failed for stability, as they could not be subjected to immediate loading. One of these 2 implants, in a healed site of a posterior maxilla, had to be removed, yielding an overall 1-year implant survival rate of 98.4%. No complications were reported. No significant differences were reported between the 2 groups with respect to implant failures and complications. CONCLUSION: Immediately loaded implants placed in postextraction sockets and healed sites had similar high survival and stability, with no reported complications. Further long-term studies on larger samples of patients are needed to confirm these results.

Effects of Collagen Grafting on Cell Behaviors in BCP Scaffold with Interconnected Pore Structure.

BACKGROUND: This study was to investigate the effect of collagen grafted porous biphasic calcium phosphate (BCP) on cell attachment, proliferation, and differentiation. Porous BCP scaffolds with interconnected micropore structure were prepared with were prepared and then grafted with a collagen type I. The hydroxyapatite (HA) and ß-tricalcium phosphate (TCP) ratio of the TCP scaffolds was about 60/40 and the collagen was crosslinked on the TCP scaffold surface (collagen-TCP). RESULTS: The sintered BCP scaffolds showed fully interconnected micropore structures with submicron-sized grains. The collagen crosslinking in the scaffolds was conducted using the the N-(3-Dimethylaminopropyl)-N'-ethylcarbodiimide hydrochloride and N-hydroxysuccinimide (NHS) crosslinking method. The cell proliferation of collagen-BCP scaffolds showed a similar result to that of the BCP scaffolds. However, osteoblastic differentiation and cell attachment increased in the collagen-BCP scaffolds. CONCLUSIONS: Collagen-BCP scaffold improved the cell attachment ability in early phase and osteoblastic differentiation.

Repair of Cranial Bone Defects Using rhBMP2 and Submicron Particle of Biphasic Calcium Phosphate Ceramics with Through-Hole.

Recently a submicron particle of biphasic calcium phosphate ceramic (BCP) with through-hole (donut-shaped BCP (d-BCP)) was developed for improving the osteoconductivity. This study was performed to examine the usefulness of d-BCP for the delivery of osteoinductive rhBMP2 and the effectiveness on cranial bone regeneration. The d-BCP was soaked in rhBMP2 solution and then freeze-dried. Scanning electron microscope (SEM), energy dispersive spectroscopy (EDS), and Raman spectroscopy analyses confirmed that rhBMP2 was well delivered onto the d-BCP surface and the through-hole. The bioactivity of the rhBMP2/d-BCP composite was validated in MC3T3-E1 cells as an in vitro model and in critical-sized cranial defects in C57BL/6 mice. When freeze-dried d-BCPs with rhBMP2 were placed in transwell inserts and suspended above MC3T3-E1, alkaline phosphatase activity and osteoblast-specific gene expression were increased compared to non-rhBMP2-containing d-BCPs. For evaluating in vivo effectiveness, freeze-dried d-BCPs with or without rhBMP2 were implanted into critical-sized cranial defects. Microcomputed tomography and histologic analysis showed that rhBMP2-containing d-BCPs significantly enhanced cranial bone regeneration compared to non-rhBMP2-containing control. These results suggest that a combination of d-BCP and rhBMP2 can accelerate bone regeneration, and this could be used to develop therapeutic strategies in hard tissue healing.

The effect of the thread depth on the mechanical properties of the dental implant.

PURPOSE: This study aimed to evaluate the effect of implant thread depth on primary stability in low density bone. MATERIALS AND METHODS: The insertion torque was measured by inserting Ti implants with different thread depths into solid rigid polyurethane blocks (Sawbones) with three different bone densities (0.16 g/cm(3), 0.24 g/cm(3), and 0.32 g/cm(3)). The insertion torque value was evaluated with a surgical engine. The static compressive strength was measured with a universal testing machine (UTM) and the Ti implants were aligned at 30° against the loading direction of the UTM. After the static compressive strength test, the Ti implants were analyzed with a Measurescope. RESULTS: The Ti implants with deeper thread depth showed statistically higher mean insertion torque values (P<.001). Groups A and group B had similar maximum static compressive strengths, as did groups C and D (P>.05). After the static compressive strength, the thread shape of the Ti implants with deeper thread depth did not show any breakage but did show deformation of the implant body and abutment. CONCLUSION: The implants with deeper thread depth had higher mean insertion torque values but not lower compressive strength. The deep threads had a mechanical stability. Implants with deeper thread depth may increase the primary stability in areas of poor quality bone without decreasing mechanical strength.

The cytocompatibility and osseointegration of the Ti implants with XPEED® surfaces.

OBJECTIVES: This study evaluated cytocompatibility and osseointegration of the titanium (Ti) implants with resorbable blast media (RBM) surfaces produced by grit-blasting or XPEED(®) surfaces by coating of the nanostructured calcium. MATERIAL AND METHODS: Ti implants with XPEED(®) surfaces were hydrothermally prepared from Ti implants with RBM surfaces in a solution containing alkaline calcium. The surface characteristics were evaluated by using a scanning electron microscope (SEM) and surface roughness measuring system. Apatite formation was measured with SEM after immersion in modified-simulated body fluid and the amount of calcium released was measured by inductively coupled plasma optical emission. The cell proliferation was investigated by MTT assay and the cell attachment was evaluated by SEM in MC3T3-E1 pre-osteoblast cells. Thirty implants with RBM surfaces and 30 implants with XPEED(®) surfaces were placed in the proximal tibiae and in the femoral condyles of 10 New Zealand White rabbits. The osseointegration was evaluated by a removal torque test in the proximal tibiae and by histomorphometric analysis in the femoral condyles 4 weeks after implantation. RESULTS: The Ti implants with XPEED(®) surfaces showed a similar surface morphology and surface roughness to those of the Ti implants with RBM surfaces. The amount of calcium ions released from the surface of the Ti implants with XPEED(®) surfaces was much more than the Ti implants with RBM surfaces (P < 0.05). The cell proliferation and cell attachment of the Ti implants showed a similar pattern to those of the Ti implants with RBM surfaces (P > 0.1). Apatite deposition significantly increased in all surfaces of the Ti implants with XPEED(®) surfaces. The removable torque value (P = 0.038) and percentage of bone-to-implant contact (BIC%) (P = 0.03) was enhanced in the Ti implants with XPEED(®) surfaces. CONCLUSION: The Ti implants with XPEED(®) surfaces significantly enhanced apatite formation, removal torque value, and the BIC%. The Ti implants with XPEED(®) surfaces may induce strong bone integration by improving osseointegration of grit-blasted Ti implants in areas of poor quality bone.

Increase of BM-MSC proliferation using L-DOPA on titanium surface in vitro.

In order to increase biocompatibility, many dental implants have been studied by immobilization of biomolecules on biomaterials. We used l-3,4-dihydroxyphenylalanine (L-DOPA) as a biomolecule for surface-modified titanium. Water contact angles of nontreated titanium discs (negative control), etched titanium discs (positive control), and titanium discs treated with L-DOPA following the etching process (experimental group) were 82.4 ± 5.7°, 67.1 ± 0.56°, and 44.15 ± 0.91°, respectively. Using atomic force microscopy images, we were able to find L-DOPA, which adhered to the titanium surface. The number of human bone marrow mesenchymal stem cells (BM-MSCs) in the experimental group was much higher than that of cells in any other group. Quantification values of amine groups in the positive control and experimental groups were approximately 3 and 7.5 µg, respectively. Therefore, findings from our research suggested the possibility of a causal link between increased L-DOPA content and cell proliferation in BM-MSCs. Moreover, coating of the discs with L-DOPA can result in greater hydrophilicity of the titanium surface and enhancement of cell adhesion and mitochondrial activity.

Adriamycin-incorporated nanoparticles of deoxycholic acid-conjugated dextran: antitumor activity against CT26 colon carcinoma.

In this study, we prepared adriamycin (ADR)-encapsulated nanoparticles using deoxycholic acid-conjugated dextran (DexDA). Its antitumor activity was evaluated using CT 26 tumor cells in vitro and in vivo. ADR-incorporated DexDA nanoparticles have spherical shapes and their particle sizes were ranged about 50-200. Their particle sizes were changed according to the preparation conditions, i.e., the higher substitution degree (DS) of deoxycholic acid (DA) and higher drug feeding ratio induced increased particle size and zeta potential. Furthermore, the higher DS of DA and higher drug feeding ratio induced increased drug contents and loading efficiency of drug. The higher DS of DA and higher drug feeding ratio induced decreased drug release rate. Futhermore, acidic pH of release media accelerated the drug release rate compared to alkaline pH. At in vitro cytotoxicity test using CT26 tumor cells, the nanoparticles showed higher antitumor activity than free ADR. In fluorescence microscopic observation, nanoparticles were properly entered into tumors cells and maintained in the cells compared to ADR itself. At in vivo animal tumor model using CT-26 cells, nanoparticles resulted in survivability increase of mice even though free ADR showed higher effectiveness to inhibit tumor growth. These results suggested that ADR-incorporated DexDA nanoparticles are promising vehicles for anti-tumor drug delivery.

Comparative study on the cellular activities of osteoblast-like cells and new bone formation of anorganic bone mineral coated with tetra-cell adhesion molecules and synthetic cell binding peptide.

PURPOSE: We have previously reported that tetra-cell adhesion molecule (T-CAM) markedly enhanced the differentiation of osteoblast-like cells grown on anorganic bone mineral (ABM). T-CAM comprises recombinant peptides containing the Arg-Gly-Asp (RGD) sequence in the tenth type III domain, Pro-His-Ser-Arg-Asn (PHSRN) sequence in the ninth type III domain of fibronectin (FN), and the Glu-Pro-Asp-Ilu-Met (EPDIM) and Tyr-His (YH) sequence in the fourth fas-1 domain of ßig-h3. Therefore, the purpose of this study was to evaluate the cellular activity of osteoblast-like cells and the new bone formation on ABM coated with T-CAM, while comparing the results with those of synthetic cell binding peptide (PepGen P-15). METHODS: To analyze the cell viability, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was performed, andto analyze gene expression, northernblot was performed. Mineral nodule formations were evaluated using alizarin red stain. The new bone formations of each group were evaluated using histologic observation and histomorphometrc analysis. RESULTS: Expression of alkaline phosphatase mRNA was similar in all groups on days 10 and 20. The highest expression of osteopontin mRNA was observed in the group cultured with ABM/P-15, followed by those with ABM/T-CAM and ABM on days 20 and 30. Little difference was seen in the level of expression of collagen type I mRNA on the ABM, ABM/T-CAM, and ABM/P-15 cultured on day 20. There were similar growth and proliferation patterns for the ABM/T-CAM and ABM/P-15. The halo of red stain consistent with Ca(2+) deposition was wider and denser around ABM/T-CAM and ABM/P-15 particles than around the ABM particles. The ABM/T-CAM group seemed to have bone forming bioactivity similar to that of ABM/P-15. A complete bony bridge was seen in two thirds of the defects in the ABM/T-CAM and ABM/P-15 groups. CONCLUSIONS: ABM/T-CAM, which seemed to have bone forming bioactivity similar to ABM/P-15, was considered to serve as effective tissue-engineered bone graft material.

Healing of rabbit calvarial bone defects using biphasic calcium phosphate ceramics made of submicron-sized grains with a hierarchical pore structure.

OBJECTIVES: This study investigated the efficacy of new bone graft substitutes - biphasic calcium phosphates (BCP) made of submicron-sized grains with fully interconnected wide-range micron-scale pores in two different macrodesigns: donut shaped with a 300-400 microm central macropore (n-BCP-1) or rod-shaped (n-BCP-2)--in the healing of rabbit calvarial defects, and compared their bone-healing properties with those of various commercial bone substitutes, which included substitutes with similar BCP composition (MBCP and Osteon), anorganic bovine bone (Bio-Oss), and beta-TCP (Cerasorb). MATERIAL AND METHODS: The surface morphology of the bone substitutes was investigated using scanning electron microscopy (SEM). Defects 8 mm in diameter were created in the calvaria of 30 adult male New Zealand White rabbits and were filled with six types of bone substitutes. The percentage of newly formed bone (NB%) was evaluated histomorphometrically 4 and 8 weeks after implantation. RESULTS: SEM observation showed submicron-sized grains with fully interconnected micropore structures in the n-BCP-1 and n-BCP-2 groups; these groups also showed considerable new bone formation in inner micropores as well as on the outer surfaces. The n-BCP-1 group exhibited enhanced new bone formation and direct ingrowth of bone tissue with blood vessels into central pores. Histomorphometric analysis showed significantly greater NB% in the n-BCP-1 group when compared with the other groups at 4 and 8 weeks (P<0.05). CONCLUSION: A new BCP ceramics made of submicron-sized grains with a hierarchical pore structure was an effective osteoconductive material for the treatment of osseous defects of rabbit calvaria.

Guided bone regeneration by poly(lactic-co-glycolic acid) grafted hyaluronic acid bi-layer films for periodontal barrier applications.

A novel protocol for the synthesis of biocompatible and degradation controlled poly(lactic-co-glycolic acid) grafted hyaluronic acid (HA-PLGA) was successfully developed for periodontal barrier applications. HA was chemically modified with adipic acid dihydrazide (ADH) in the mixed solvent of water and ethanol, which resulted in a high degree of HA modification up to 85 mol.%. The stability of HA-ADH to enzymatic degradation by hyaluronidase increased with ADH content in HA-ADH. When the ADH content in HA-ADH was higher than 80 mol.%, HA-ADH became soluble in dimethyl sulfoxide and could be grafted to the activated PLGA with N,N'-dicyclohexyl carbodiimide and N-hydroxysuccinimide. The resulting HA-PLGA was used for the preparation of biphasic periodontal barrier membranes in chloroform. According to in vitro hydrolytic degradation tests in phosphate buffered saline, HA-PLGA/PLGA blend film with a weight ratio of 1/2 degraded relatively slowly compared to PLGA film and HA coated PLGA film. Four different samples of a control, OSSIX(TM) membrane, PLGA film, and HA-PLGA/PLGA film were assessed as periodontal barrier membranes for the calvarial critical size bone defects in SD rats. Histological and histomorphometric analyses revealed that HA-PLGA/PLGA film resulted in the most effective bone regeneration compared to other samples with a regenerated bone area of 63.1% covering the bone defect area.

Effects of calcium ion incorporation on bone healing of Ti6Al4V alloy implants in rabbit tibiae.

The biocompatibility of calcium ion (Ca)-incorporated Ti6Al4V alloy implants, produced by hydrothermal treatment using a Ca-containing solution, was investigated. The surface characteristics were evaluated by scanning electron microscopy, thin-film X-ray diffractometry, Auger electron spectroscopy, and stylus profilometry. The viability of MC3T3-E1 cells on Ca-incorporated machined Ti6Al4V surfaces with different oxide thicknesses was compared with that on untreated machined Ti6Al4V surfaces with MTT assay. The osteoconductivity of the Ca-incorporated Ti6Al4V implants was evaluated by removal torque testing and histomorphometric analysis after 6 weeks of implantation in rabbit tibiae. Our results show that hydrothermal treatment with a Ca-containing solution produced a crystalline CaTiO(3) layer on Ti6Al4V surfaces, and calcium ions were gradually incorporated throughout the oxide layer. After immersion in Hank's balanced salt solution, a considerable apatite deposition was observed on all surfaces of the Ca-incorporated samples. Significant increases in cell viability (p<0.001), removal torque forces, and bone-to-implant contact values (p<0.05) were observed for Ca-incorporated Ti6Al4V implants compared with those for untreated Ti6Al4V implants.