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Biomedical subjects

Ann Wennerberg

Publications and source records attributed to Ann Wennerberg.

32 records · Page 2Linked to original sources

The influence of a chemo-mechanical caries removal solution on the topography of dental ceramic materials.

The purpose of this study was to investigate the chemical influence of chemo-mechanical caries removal (CMCR) on surface topography of dental ceramic materials. Thirty samples of three different types of ceramics (Vita Omega, Vita Alpha, and Procera AllTitan) were manufactured and used. With an optical profilometer, designed with a confocal setting of its optics, (CLSP). and an atomic force microscope (AFM) the surface topography of the specimens was investigated at two different resolutions. The specimens were exposed to a solution (64 mm NaOCl, 27 mM amino acids, pH = 11) supposed to be more aggressive than Carisolv (34 mm NaOCl, 53mM amino acids, pH = 11), a CMCR system commercially available. After exposure for 5, 10, and 20 min, respectively, areas measured were relocated and the surface topography was reinvestigated. Parameters describing the amplitude, spatial, and hybrid topographical variation were calculated. In general, after 20 min CMCR solution exposure, the AFM topographical parameters were reduced for Vita Omega, and increased for Vita Alpha", whereas the CLSP topographical parameters of Procera AllTitan were slightly reduced. Thus, the results of this study showed minor influence on surface topography after exposure to CMCR solution for 20 min on the dental ceramics Vita Omega, Vita Alpha, and Procera AllTitan.

Dental Caries↗

Does sodium fluoride in bone cement affect implant fixation? Part I: bone tissue response, implant fixation and histology in nine rabbits.

The addition of sodium fluoride to poly (methyl-methacrylate) (PMMA) bone cement may theoretically improve the fixation of joint replacement. This hypothesis was tested in an animal model using nine mature healthy lop-eared rabbits. A femoral prosthesis was inserted in both knees to resurface the patellofemoral articulation. The same acrylic cement, with and without sodium fluoride, was randomised between the two sides for prosthetic fixation. Two screw shaped implants machined from cured rods of either cement were also inserted bilaterally into the proximal tibia. Qualitative and quantitative histomorphometry of the bone tissue response surrounding the cement in the femur and the intact tibial implants revealed similar results regardless of sodium fluoride addition. Six weeks after surgery removal, torque did not significantly differ between the two sides. Our findings indicate that addition of sodium fluoride to PMMA has little effect on implant stability and bone remodeling in rabbits in the short-term.

Journal Article↗

Does sodium fluoride in bone cement affect implant fixation. Part II: evaluation of the effect of sodium fluoride additions to acrylic bone cement and the fixation of titanium implants in ovariectomized rabbits.

Bone integration of threaded implants made of cured polymethylmethacrylate containing sodium fluoride or commercially pure (c.p.) titanium were studied in normal and estrogen deficient New Zealand white rabbits. Nine had been ovariectomized through laparoscopy and nine served as controls. Four weeks after the ovariectomy two threaded implants made of cured bone cement with or without sodium fluoride addition were inserted in each tibia. One threaded commercially pure titanium implant was inserted in each patello-femoral joint flush to the cartilage. Six weeks after implant insertion measurement of the peak removal torque necessary to loosen the implants and light microscopical histomorphometrical investigations of tissue integration were performed. In the ovariectomized rabbits addition of sodium fluoride to the cement resulted in increased area of bone in the threads (p=0.04), but no corresponding effect could be noted in the controls. The removal torque was lower in the ovariectomized rabbits compared to the non-ovariectomized when comparing implant with sodium fluoride addition (p=0.02). The bone tissue response and the removal torque of the titanium implants were not influenced by ovariectomy in these rabbits.

Journal Article↗

The effect of titanium surface roughness on the adhesion of monocytes and their secretion of TNF-alpha and PGE2.

Dental implant surfaces are important in determining the tissue/surface interaction. One of the first cells to adhere to the implant surface is the monocyte. This study examines the effect of surface roughness on monocyte adhesion and cytokine secretion. Monocyte adherence to titanium discs of 4 different degrees of surface roughness and plastic surfaces was assayed. Blood mononuclear cells were incubated for 1.5 h in 16 mm culture wells into which titanium discs had been placed. Non-adherent cells were washed off and the numbers of remaining adherent monocyte determined by DNA quantification. TNF-alpha and PGE2 secretion in media from overnight cultures of attached monocytes stimulated with lipopolysaccharide (LPS) was quantified using ELISA and RIA, respectively. Monocyte adherence to rough titanium surfaces was greater than to turned titanium surfaces, while the lowest adherence was to the plastic surface. No significant differences in adherence to 250, 75 or 25 microm blasted surfaces could be detected. The number of adherent monocytes increased with time, with maximum adhesion after 2 h of incubation. Incubation of monocytes adherent to titanium surfaces resulted in a decrease of less than 30% in their numbers over 7 days, whereas cells attached to plastic surfaces decreased to non-detectable numbers after 48 h. Porphyromonas gingivalis LPS stimulation upregulated TNF-alpha and PGE2 secretion into the media. The LPS-induced TNF-alpha and PGE2 secretion was independent of the titanium surface roughness, however the lowest amounts of TNF-alpha and PGE2 were secreted from cells attached to plastic surfaces. The results of this study indicate that the number of monocytes attached to blasted titanium surfaces is significantly greater than to machined titanium surfaces. PGE2 and TNF-alpha secretion is less influenced by titanium surface roughness.

Analysis of Variance↗

Resonance frequency and removal torque analysis of implants with turned and anodized surface oxides.

The present experimental study was designed to address two issues. The first was to investigate whether oxide properties of titanium implants influenced bone tissue responses after an in vivo implantation time of six weeks. If such a result was found, the second aim was to investigate which oxide properties are involved in such bone tissue responses. Screw-shaped implants with a wide range of oxide properties were prepared by electrochemical oxidation methods, where the oxide thickness varied in the range of 200 nm to 1000 nm. The surface morphology was prepared in two substantially different ways, i.e. barrier and porous oxide film structures. The micropore structure revealed pore sizes of 8 microm in diameter, with a range in opening area from 1.27 microm 2 to 2.1 microm 2. Porosity ranged from 12.7% to 24.4%. The crystal structures of the titanium oxide were amorphous, anatase and a mixture of anatase and rutile type. The chemical compositions consisted mainly of TiO2. Surface roughness ranged from 0.96 microm to 1.03 microm (Sa). Each group of test samples showed its own, defined status with respect to these various parameters. The oxide properties of turned commercially pure titanium implants were used in the control group, which was characterized by an oxide thickness of 17.4 +/- 6.2 nm, amorphous type in crystallinity, TiO2 in chemical composition, and a surface roughness of 0.83 microm (Sa). Bone tissue responses were evaluated by resonance frequency measurements and removal torque tests that were undertaken six weeks after implant insertion in rabbit tibia. Implants that had an oxide thickness of approximately 600, 800 and 1000 nm demonstrated significantly stronger bone responses in the evaluation of removal torque values than did implants that had an oxide thickness of approximately 17 and 200 nm (P < 0.05). However, there were no difference between implants with oxide thicknesses of 17 and 200 nm (P = 0.99). It was concluded that oxide properties of titanium implants, which include oxide thickness, micropore configurations and crystal structures, greatly influence the bone tissue response in the evaluation of removal torque values. However, it is not fully understood whether these oxide properties influence the bone tissue response separately or synergistically.

Animals↗

Chemical and topographical analyses of dentine surfaces after Carisolv treatment.

OBJECTIVES: The aim of this study was to characterise the surface chemistry of cavities after chemomechanical caries excavation, and also to measure the surface topography after caries removal with Carisolv or burs, followed by acid etching. METHODS: Fourier transform (FT)-Raman spectroscopy was used to study the relative amounts of organic material and minerals of sound enamel, dentine, and cavities, after caries excavation. Fourier transform infrared spectroscopy (FTIR) and laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) were used for detection of Carisolv substances (i.e. mainly sodium hypochlorite, amino acids, and the gelling agent carboxymethyl cellulose). In total, 19 carious and 11 sound extracted teeth were used for the chemical analyses. Topographic examination of 30 carious extracted teeth was performed with a contact profilometer. RESULTS: The relative amounts of organic material and minerals did not significantly differ between sound dentine and the cavities after caries removal with burs or Carisolv. The FTIR analyses indicated extremely small amounts of Carisolv substances at the cavity surface, but the LA-ICP-MS analyses did not confirm those findings. Furthermore, the topographical parameters did not significantly differ between etched cavities after caries removal using burs or Carisolv. CONCLUSIONS: The chemical and topographical analyses in the present study imply that any differences between the cavities after caries excavation with burs or with Carisolv are insignificant.

Acid Etching, Dental↗

Histologic evaluation of bone response to oxidized and turned titanium micro-implants in human jawbone.

PURPOSE: To evaluate the human bone tissue response to 2 surfaces (oxidized or turned) on commercially available titanium implants. MATERIALS AND METHODS: Screw-type turned (control) and oxidized (test) micro-implants were manufactured in the same manner as commercially available turned and oxidized (TiUnite, Brånemark System) implants. The thickness of the oxide layer of the test implants was on average 10 microm, corresponding to the oxide thickness of the apical part of the TiUnite implant. Twenty patients received 1 test and 1 control micro-implant each during implant surgery. Before placement, the surface topography of the implants was characterized with an optical confocal laser profilometer. After a mean healing period of 6.6 months in the maxilla and 3.5 months in the mandible, the micro-implants and surrounding tissue were removed with a trephine bur. Histologic sections were produced, and the specimens were analyzed histomorphometrically. RESULTS: Surface roughness and enlargement were greater for the oxidized implants than for the turned implants. All micro-implants, except for 2 controls, were found to be clinically stable at the time of retrieval. Histomorphometric evaluation demonstrated significantly higher bone-to-implant contact for the oxidized implants, whether placed in the maxilla or in the mandible. Significantly more bone was found inside the threaded area for the oxidized implants placed in the mandible and maxilla, but there was no difference between implants with regard to position (maxilla or mandible). DISCUSSION: The stronger bone response to the oxidized implants may have contributed to the fact that 2 control implants but no test implants were lost. The reason for these findings may depend on one or multiple differences of the surfaces between test and control implants: (1) the thicker oxide layer itself, (2) increased surface roughness, (3) different surface morphology in terms of porosity, or (4) change in crystal structure. CONCLUSION: The present histologic study in human jawbone demonstrated a significantly higher bone response for anodic oxidized titanium implants than for implants with a turned surface.

Aged↗

A histomorphometric analysis of the effects of various surface treatment methods on osseointegration.

PURPOSE: One major factor in the success and biocompatibility of an implant is its surface properties. The purposes of this study were to analyze the surface characteristics of implants after blasting and thermal oxidation and to evaluate the bone response around these implants with histomorphometric analysis. MATERIALS AND METHODS: Threaded implants (3.75 mm in diameter, 8.0 mm in length) were manufactured by machining a commercially pure titanium (grade 2). A total of 48 implants were evaluated with histomorphometric methods and included in the statistical analyses. Two different groups of samples were prepared according to the following procedures: Group 1 samples were blasted with 50-microm aluminum oxide (Al2O3) particles, and group 2 samples were blasted with 50-microm Al2O3, then thermally oxidized at 800 degrees C for 2 hours in a pure oxygen atmosphere. A noncontacting optical profilometer was used to measure the surface topography. The surface composition of the implants used and the oxide thickness were investigated with Rutherford backscattering spectrometry. RESULTS: The different preparations produced implant surfaces with essentially similar chemical composition, but with different oxide thickness and roughness. The morphologic evaluation of the bone formation revealed that: (1) the percentage of bone-to-implant contact of the oxidized implants (33.3%) after 4 weeks was greater than that of the blasted group (23.1%); (2) the percentages of bone-to-implant contact after 12 weeks were not statistically significantly different between the groups; (3) the percentages of bone area inside the thread after 4 weeks and 12 weeks were not statistically significantly different between groups. DISCUSSION AND CONCLUSION: This investigation demonstrated the possibility that different surface treatments, such as blasting and oxidation, have an effect on the ingrowth of bone into the thread. However, the clinical implications of surface treatments on implants, and the exact mechanisms by which the surface properties of the implant affect the process of osseointegration, remain subjects for further study.

Aluminum Oxide↗

Improved retention and bone-tolmplant contact with fluoride-modified titanium implants.

PURPOSE: The purpose of the present study was to investigate whether a fluoride modification of the titanium surface would have an effect on bone response after implantation. MATERIALS AND METHODS: Titanium-oxide-blasted titanium implants with and without fluoride modification were investigated in a rabbit tibia model. Quantitative analysis of surface roughness, biomechanical interlocking, and in vivo tissue reactions in rabbit bone at 1 and 3 months after placement were compared. RESULTS: The fluoride-modified test implants had a slightly smoother surface (Sa: 0.91 +/- 0.14 microm) than the unmodified control implants (Sa: 1.12 +/- 0.24 microm). Significantly higher removal torque values (85 +/- 16 Ncm vs 54 +/- 12 Ncm) and shear strength between bone and implants (23 +/- 9 N/mm2 vs 15 +/- 5 N/mm2) were measured for the fluoride-modified implants after 3 months. The histomorphometric evaluations demonstrated higher bone-to-implant contact for test implants at 1 month (35% +/- 14% vs 26% +/- 8%) and 3 months (39% +/- 11% vs 31% +/- 6%) after placement. DISCUSSION: Implant surface modification with fluoride may result in morphologic and physiochemical phenomena that are of significance for the bone response. Another possible explanation for the findings in the present study is that a surface modification changes the surface chemical structures to be more suitable for bone bonding. CONCLUSION: Based on the biomechanical and histomorphometric data, the fluoride-modified titanium implants demonstrated a firmer bone anchorage than the unmodified titanium implants. These implants achieved greater bone integration than unmodified titanium implants after a shorter healing time.

Animals↗

Oral implant surfaces: Part 1--review focusing on topographic and chemical properties of different surfaces and in vivo responses to them.

PURPOSE: This article reviews the topographic and chemical properties of different oral implant surfaces and in vivo responses to them. MATERIALS AND METHODS: The article considers detailed mechanical, topographic, and physical characteristics of implant surfaces. Anchorage mechanisms such as biomechanical and biochemical bonding are examined. Osteoattraction and doped surfaces are discussed. RESULTS: Surface quality of an oral implant may be subdivided into mechanical, topographic, and physicochemical properties. Topographic properties are evaluated at the micrometer level of resolution. Moderately rough surfaces (Sa between 1.0 and 2.0 microm) show stronger bone responses than smoother or rougher surfaces. The majority of currently marketed implants are moderately rough. Oral implants permit bone ingrowth into minor surface irregularities-biomechanical bonding or osseointegration. Additional biochemical bonding seems possible with certain surfaces. Osteoattraction is a commercial term without precise biologic correspondence. Surfaces doped with biochemical agents such as bone growth factors have been developed. CONCLUSION: Moderately roughened surfaces seem to have some clinical advantages over smoother or rougher surfaces, but the differences are small and often not statistically significant. Bioactive implants may offer some promise.

Calcium Phosphates↗

Oral implant surfaces: Part 2--review focusing on clinical knowledge of different surfaces.

PURPOSE: This article reviews clinical knowledge of selected oral implant surfaces. MATERIALS AND METHODS: The surfaces most commonly used in clinical practice, marketed by the five largest oral implant companies, are identified; their clinical documentation was scrutinized following a strict protocol. Experimental knowledge of the surfaces is briefly summarized. Retrospective, prospective, and comparative clinical studies were analyzed separately, as were studies of implants in conjunction with bone grafts. RESULTS: TiUnite anodized surfaces are clinically documented in 1- to 2-year follow-up studies at best, with failures at about 3%. Sandblasted and acid-etched SLA surfaces are documented with good clinical results for up to 3 years. Osseotite dual acid-etched implants are documented with good clinical results for up to 5 years. Frialit-2 sandblasted and etched implants are positively documented for about 3 years in one study only. The Tioblast implant is the only design documented for survival over 10 years of follow-up and success over 7 years of follow-up. CONCLUSION: Generally, oral implants are introduced clinically without adequate clinical documentation. Implant companies initiate clinical documentation after product launch. The standards of clinical reporting have improved over the years. Proper long-term reports have been published for only one surface, Tioblast.

Bone Transplantation↗

Optimum surface properties of oxidized implants for reinforcement of osseointegration: surface chemistry, oxide thickness, porosity, roughness, and crystal structure.

PURPOSE: To investigate detailed surface characterization of oxidized implants in a newly invented electrolyte system and to determine optimal surface oxide properties to enhance the bone response in rabbits. MATERIALS AND METHODS: A total of 100 screw-type titanium implants were prepared and divided into 1 control group (machine-turned implants) and 4 test groups (magnesium ion-incorporated oxidized implants). Forty implants were used for surface analyses. A total of 60 implants, 12 implants from each group, were placed in the tibiae of 10 New Zealand white rabbits and measured with a removal torque test after a healing period of 6 weeks. RESULTS: For the test groups, the oxide thicknesses ranged from about 1,000 to 5,800 nm; for the control group, mean oxide thickness was about 17 nm. The surface morphology showed porous structures for test groups and nonporous barrier film for the control group. Pore diameter ranged from < or = 0.5 microm to < or = 3.0 microm. In regard to surface roughness, arithmetic average height deviation (Sa) values varied from 0.68 to 0.98 microm for test implants and 0.55 microm for control implants; developed surface ratio (Sdr) values ranged from 10.6% to 46% for the test groups and were about 10.6% for the control group. A mixture of anatase and rutile-type crystals were observed in the test groups; amorphous-type crystals were observed in the control group. After a healing period of 6 weeks, removal torque measurements in all 4 test groups demonstrated significantly greater implant integration as compared to machine-turned control implants (P < or = .033). DISCUSSION: Determinant oxide properties of oxidized implants are discussed in association with bone responses. Of all surface properties, RTVs were linearly increased as relative atomic concentrations of magnesium ion increase. CONCLUSIONS: Surface properties of the oxidized implants in the present study, especially surface chemistry, influenced bone responses. The surface chemistry of the optimal oxidized implant should be composed of approximately 9% magnesium at relative atomic concentration in titanium oxide matrix and have an oxide thickness of approximately 1,000 to 5,000 nm, a porosity of about 24%, and a surface roughness of about 0.8 microm in Sa and 27% to 46% in Sdr; its oxide crystal structure should be a mixture of anatase- and rutile-phase crystals.

Animals↗

Fixed partial prostheses supported by 2 or 3 implants: a retrospective study up to 18 years.

PURPOSE: The purpose of this study was to evaluate and compare the long-term performance of fixed partial prostheses supported by 2 or 3 implants. MATERIALS AND METHODS: All patients treated with fixed partial prostheses supported by either 2 or 3 implants during the period 1985 to 1998 were included in this retrospective report. Annual clinical follow-up examinations were performed, with special attention to stability of the prostheses and peri-implant and occlusal conditions. Radiographic examination was performed when the prostheses were delivered (year 0) and subsequently at 1-year, 5-year, and 10-year examinations. RESULTS: A total of 178 patients had received fixed partial prostheses (FPPs) during this period of whom 123 (77 women and 46 men) were available for follow-up (mean age = 65 years, range 32-91). These 123 patients received a total of 146 implant-supported FPPs (63 two-implant- and 83 three-implant-supported) supported by 375 implants. The mean observation periods for the 2- and 3-implant-supported restorations were 9.6 years and 9.4 years (range, 5 to 18 years), respectively. Survival rates for the 2- and 3-implant-supported prostheses were 96.8% and 97.6%, respectively. The implant survival rate after loading was 98.4% for both groups. The mean bone loss at the 5-year follow-up was 0.3 mm for the 2 groups. No significant differences in bone loss (P > .05), implant failure rate (P > .05), or incidence of mechanical complications (P > .05) were found between the 2 prosthesis designs. The complications differed, significantly, with more loose gold and abutment screws in the 2-implant-supported group (P < .05) and more porcelain fractures in the 3-implant-supported group (P < .05). CONCLUSION: The 2-implant-supported partial prostheses exhibited long-term clinical performance comparable to prostheses supported by 3 implants.

Adult↗