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PubMed2005

[Histomorphometric evaluation of bone ingrowth of porous titanium by a computer-assisted analyzing system].

The objective of this study was to evaluate the bone ingrowth of a new vacuum plasma sprayed titanium surface (vps-ti) in comparison to cs-titanium implants in a göttinger minipig model. Fifteen göttinger minipigs each received the two implants, vacuum plasma sprayed titanium with a porosity of 50% and a pore size of 200 microm (vps-ti) and an implant with a similar porosity but a different pore size 500 microm (cs-ti), at the proximal femur metaphysis by press-fit technique. The pigs were euthanized at three different postsurgical periods: 4, 8 and 12 weeks. Each femur was harvested and qualitative (macroscopic and microscopic) and quantitative (histomorphometric) histological analysis was done on histological slides. The results indicated that there was a difference in bone ingrowth between the two implants, whereas the bone ingrowth of vps-ti was superior to cs-ti after 4 and 8 weeks healing time. 12 weeks post implantationem no statistiscal difference was evident. The pore size of 200 microm seemed superior to a pore size of 500 microm. Whether or not these effects lead to a better mechanical stability remains unanswered.

Animals↗
PubMed1998

[Characterization of the properties of differentially modified titanium surfaces for dental implantology. 2: In vitro biocompatibility studies].

The aim of the present study was to determine whether specific surface modifications are capable of improving the biocompatibility of a titanium surface, and whether there is a correlation between the physico-chemical properties of the implant material and its biocompatibility. To this end, the properties of titanium surfaces were modified using various methods or the latter were coated with various materials. Plasma treatments under different atmospheric conditions (N2-plasma, SO2-plasma, acetylene plasma) as well as plasma polymerization were used to affect the biological response. Characterization of the physico-chemical surface properties by means of X-ray photoelectron spectroscopy (XPS), contact angle measurements and the calculation of surface tensions or surface energy provided important information on the interactions at the interface between the implant material and the aqueous environment. The influence of the respective surface modification on cell proliferation, cell viability and the activity of mitochondrial dehydrogenases was evaluated in specific in vitro tests with human gingiva fibroblasts. It was show that different modifications of the titanium samples induce different biological responses of the gingiva fibroblasts. The results confirm the existence of correlations between thermodynamic surface properties and cellular reactions under in vitro conditions.

Cell Division↗
PubMed2002

Clinical radiographic, and histologic evaluation of maxillary bone reconstruction by using a titanium mesh and autogenous iliac graft: a case report.

The current clinical report describes the use of titanium mesh for maxillary alveolar ridge augmentation. Autogenous bone graft was harvested from the iliac crest and was loaded on a titanium mesh that was left in the patient's maxilla for 7 months before it was removed. Twelve months after the bone grafting procedure the patient received 10 implants on the maxilla, and a biopsy was taken from the augmented ridge. CT scan examination was performed before and after the maxillary ridge augmentation. Clinical evaluation revealed successful integration of the graft. The radiographic analysis demonstrated that a 10-mm vertical ridge augmentation had been achieved. Histologic evaluation revealed remnants of the autogenous bone graft still present, whereas the grafted area had a reduced remodeling activity. The clinical report demonstrated the potential of the titanium mesh to achieve extensive alveolar ridge augmentation, whereas the augmented ridge may possess an inferior capability forbone remodeling.

Aged↗
PubMed2004

Titanium pigment in tissues of drug addicts: report of 5 necropsied cases.

The aim of this report is to describe the anatomic-pathologic findings from necropsies of 5 drug addicts with titanium pigment in several organs after chronic intravenous injection of crushed propoxyphene hydrochloride tablets. Samples from liver, spleen, lungs, lymph nodes, and bone marrow were obtained, and after being grossly studied, they were submitted to evaluation using common light and polarized microscopy. In all 5 cases, a pigment with characteristics of titanium dioxide was found within tissue samples of the organs studied. Our findings suggest that research concerning titanium pigment within body tissues should be enhanced, considering the potential contribution of this morphologic data to forensic pathology.

Adult↗
PubMed2006

Vickers hardness of cast commercially pure titanium and Ti-6Al-4V alloy submitted to heat treatments.

The purpose of this study was to evaluate the effect of heat treatments on the Vickers hardness of commercially pure titanium and Ti-6Al-4V cast alloys. Six-millimeter-diameter cylindrical specimens were cast in a Rematitan System. Commercially pure titanium and Ti-6Al-4V alloy specimens were randomly assigned to 3 groups (n=10) that received the following heat treatments: control (no heat treatment); treatment 1 (T1): heating at 750 degrees C for 2 h; and treatment 2 (T2): annealing at 955 degrees C for 1 h and aging at 620 degrees C for 2 h. After heat treatments, the specimens were embedded in acrylic resin and their surface was ground and polished and hardness was measured. Vickers hardness means (VHN) and standard deviations were analyzed statistically by Kruskal-Wallis test at 5% significance level. For commercially pure titanium, Vickers hardness means of group T2 (259.90 VHN) was significantly higher than those of the other groups (control--200.26 VHN and T1--202.23 VHN), which presented similar hardness means to each other (p>0.05). For Ti-6Al-4V alloy, statistically significant differences were observed among the three groups: T2 (369.08 VHN), T1 (351.94 VHN) and control (340.51 VHN) (p<0.05). The results demonstrated different hardness of CP Ti and Ti-6Al-4V when different heat treatments were used. For CP Ti, VHN means of T2 group was remarkably higher than those of control and T1 group, which showed similar VHN means to each other. For Ti-6Al-4V alloy, however, VHN means recorded for each group may be presented as follows: T2>T1>control.

Alloys↗
PubMedDate not supplied

[Optimization of implant surfaces: titanium plasma spray and acid-etched sandblasting -- current status].

The aim of this review was to update the concepts regarding the preparation of the surfaces of titanium implants, focusing on TPS (titanium plasma-sprayed implants) and SLA (sandblasted and acid etched implants). Texture was the most remarkable isolated feature, regarded as an osseointegration promoter. In a comprehensive review of the effects of implant surface topography on cell behavior, one can verify that there is bone apposition onto the implant surface regardless of its characteristics: polished or rough, made of titanium or ceramic. Roughness is not mandatory for bone apposition. However, it has been shown that roughness may play an important role in the percentage of bone apposition as well as in the velocity of apposition. In this review, a quite promising type of surface called SLA is pointed out, showing that either roughness or acid conditioning of the surfaces can significantly improve shear strength. Besides optimizing the procedure, these surface characteristics may, eventually, allow for an earlier loading of the implant and extend the indications for implants in low-density alveolar bone and in regenerated bone.

Dental Implantation, Endosseous↗
PubMed2005

Characterization of titanium surfaces for dental implants with inorganic contaminant.

The aim of this research was to characterize titanium surfaces blasted with aluminum oxide (Al2O3) particles using the KS 400 digital image processing program. Samples of grade II titanium plates were submitted to blasting processes using particles of Al2O3, and treated with a hydrofluoric acid-based solution. Three digital images from each sample surface were obtained using Scanning Electron Microscopy, and half-quantitative chemical analyses were subsequently performed using Electron Dispersive Spectroscopy (EDS). In addition, parameters related to the alumina phase, such as the concentration level, the area and perimeter of the particles and their circular form factor were measured using KS 400. The mechanical/chemical treatment caused depressions up to 10 microm on homogeneous surfaces. Although the chemical attack significantly removed the alumina phase, residual particles could still be identified by the EDS. The average area occupied by the alumina phase on the samples surfaces was 469.32 (+/- 284.98) microm2, the particle average perimeter was 81.61 (+/- 27.68) microm, and the mean circular form factor was 0.60 (+/- 0.05). Characterizing the titanium surface is essential in the evaluation of the material manufacturing process because the presence of residual aluminum particles may have deleterious effects on the formation of the osseous/implant tissue.

Aluminum Oxide↗
PubMed2005

Influence of PMMA shielding on DNA fragmentation induced in human fibroblasts by iron and titanium ions.

In the framework of a collaborative project on the influence of the shielding on the biological effectiveness of space radiation, we studied DNA fragmentation induced by 1 GeV/nucleon iron ions and titanium ions with and without a 197-mm-thick polymethylmethacrylate (PMMA) shield in AG1522 human fibroblasts. Pulsed- and constant-field gel electrophoresis were used to analyze DNA fragmentation in the size range 1-5700 kbp. The results show that, mainly owing to a higher production of small fragments (1-23 kbp), titanium ions are more effective than iron ions at inducing DNA double-strand breaks (DSBs), their RBE being 2.4 and 1.5, respectively. The insertion of a PMMA shield decreases DNA breakage, with shielding protection factors (ratio of the unshielded/shielded cross sections for DSB production) of about 1.6 for iron ions and 2.1 for titanium ions. However, the DSB yield (no. of DSBs per unit mass per unit dose) is almost unaffected by the presence of the shield, and the relative contributions of the fragments in the different size ranges are almost the same with or without shielding. This indicates that, under our conditions, the effect of shielding is mainly to reduce the dose per unit incident fluence, leaving radiation quality practically unaffected.

Cells, Cultured↗
PubMed1994

Expanded polytetrafluoroethylene titanium-reinforced membranes for regeneration of mucogingival recession defects. A 12-case report.

The regeneration of tissue to treat mucogingival recession defects is well established but these defects pose additional challenges for the clinician in the creation and maintenance of a space under the guiding membrane. We used titanium-reinforced membranes of expanded polytetrafluoroethylene (ePTFE) to facilitate the creation and maintenance of such spaces in 12 patients with mucogingival recession defects. The membranes were judged according to their ease of handling and placement and the regenerative results; the patients were evaluated for gingival recession and the quantity of attached gingiva before and for as long as 15 months after treatment. At 15 months, the average gingival recession was 1.4 mm (pretreatment = 5.3 mm), and the attached gingiva measured 3.3 mm (pretreatment = 1.4 mm). Titanium-reinforced ePTFE membranes result in a simpler, faster, and more predictable surgical procedure. Comparison of titanium-reinforced ePTFE membranes to other available procedures awaits assessment in clinical trials.

Adolescent↗
PubMed1995

The effects of scaling procedures on epithelial cell growth on titanium surfaces.

This study examined in vitro epithelial cell growth on titanium surfaces which had been instrumented by 3 types of periodontal curets. Commercially pure titanium discs were uniformly scaled using plastic, stainless steel, or gold-coated curets and then seeded with a microdot (50,000 cells per 10 microliters) of rat gingival epithelial cells. After 5 days of growth, epithelial cell surface area (mm2) coverage was measured on photographed specimens using a computer digitizing system. Scanning electron microscopic evaluation showed a denser central core of cellular growth on the stainless steel-treated surfaces as compared to the other surface treatments. Epithelial surface area coverage on the stainless steel, plastic, and control groups did not vary significantly among groups. However the gold-coated curet exposed surfaces supported significantly less epithelial growth than the stainless steel and control surfaces. A better understanding of in vitro epithelial cell responses to different titanium surface characteristics will assist in designing implant scaling procedures which allow maintenance of the implant perimucosal seal.

Animals↗
PubMed1997

The effect of surface roughness on early in vivo plaque colonization on titanium.

THE STUDY ASSESSES IN VIVO the surface roughness necessary to reduce plaque colonization on titanium after 24 hours. Three groups of 16 titanium disks were assigned to 3 different polishing groups (A, B, and C). The roughness was evaluated with a laser profilometer and the morphology with a scanning electron microscope (SEM). Eight volunteers were enrolled and two stents were applied in the mandibular posterior region of each. Each stent supported 3 disks, one per group. The volunteers suspended oral hygiene for 24 hours, after which the stents were removed; one was processed for evaluation of the adherent biomass and the other for SEM study. On each specimen a global area of 100 x 125 microns was examined with SEM. The area was composed of five 20 x 25 microns randomly selected fields. For each field the density of bacteria and the morphotypes were recorded. The data quoted for the global area are cumulative of those observed in the 20 x 25 microns fields. Group A had a significantly smoother surface than groups B and C. The adherent microbial biomass determination and SEM evaluation revealed that group A contained less bacteria than the roughest group. The bacterial population was composed of cocci in group A, and of cocci and short and long rods in groups B and C. We conclude that a titanium surface with Ra < or = 0.088 microns and Rz < or = 1.027 microns strongly inhibits accumulation and maturation of plaque at the 24-hour time period and that such smoothness can be achieved in transgingival and healing implant components.

Analysis of Variance↗
PubMed2001

Influence of the size of the microgap on crestal bone changes around titanium implants. A histometric evaluation of unloaded non-submerged implants in the canine mandible.

BACKGROUND: Endosseous implants can be placed according to a non-submerged or submerged approach and in 1- or 2-piece configurations. Recently, it was shown that peri-implant crestal bone changes differ significantly under such conditions and are dependent on a rough/smooth implant border in 1-piece implants and on the location of an interface (microgap) between the implant and abutment/restoration in 2-piece configurations. Several factors may influence the resultant level of the crestal bone under these conditions, including movements between implant components and the size of the microgap (interface) between the implant and abutment. However, no data are available on the impact of possible movements between these components or the impact of the size of the microgap (interface). The purpose of this study was to histometrically evaluate crestal bone changes around unloaded, 2-piece non-submerged titanium implants with 3 different microgap (interface) dimensions and between implants with components welded together or held together by a transocclusal screw. METHODS: A total of 60 titanium implants were randomly placed in edentulous mandibular areas of 5 hounds forming 6 different implant subgroups (A through F). In general, all implants had a relatively smooth, machined suprabony portion 1 mm long, as well as a rough, sandblasted, and acid-etched (SLA) endosseous portion, all placed with their interface (microgap) 1 mm above the bone crest level and having abutments connected at the time of first-stage surgery. Implant types A, B, and C had a microgap of < 10 microns, approximately 50 microns, or approximately 100 microns between implant components as did types D, E, and F, respectively. As a major difference, however, abutments and implants of types A, B, and C were laser-welded together, not allowing for any movements between components, as opposed to types D, E, and F, where abutments and implants were held together by abutment screws. Three months after implant placement, all animals were sacrificed. Non-decalcified histology was analyzed histometrically by evaluating peri-implant crestal bone changes. RESULTS: For implants in the laser-welded group (A, B, and C), mean crestal bone levels were located at a distance from the interface (IF; microgap) to the first bone-to-implant contact (fBIC) of 1.06 +/- 0.46 mm (standard deviation) for type A, 1.28 +/- 0.47 mm for type B, and 1.17 +/- 0.51 mm for type C. All implants of the non-welded group (D, E, and F) had significantly increased amounts of crestal bone loss, with 1.72 +/- 0.49 mm for type D (P < 0.01 compared to type A), 1.71 +/- 0.43 mm for type E (P < 0.02 compared to type B), and 1.65 +/- 0.37 mm for type F (P < 0.01 compared to type C). CONCLUSIONS: These findings demonstrate, as evaluated by non-decalcified histology under unloaded conditions in the canine mandible, that crestal bone changes around 2-piece, non-submerged titanium implants are significantly influenced by possible movements between implants and abutments, but not by the size of the microgap (interface). Thus, significant crestal bone loss occurs in 2-piece implant configurations even with the smallest-sized microgaps (< 10 microns) in combination with possible movements between implant components.

Alveolar Bone Loss↗
PubMed2004

Bacterial adhesion on commercially pure titanium and zirconium oxide disks: an in vivo human study.

BACKGROUND: Little is known about the mechanisms of bacterial interaction with implant materials in the oral cavity. A correlation between plaque accumulation and progressive bone loss around implants has been reported. Bacterial adhesion shows a direct positive correlation with surface roughness. Other surface characteristics also seem to be extremely important with regard to plaque formation. Different adhesion affinities of bacteria have been reported for different materials. The aim of this study was to characterize the percentage of surface covered by bacteria on commercially pure titanium and zirconium oxide disks. METHODS: Ten patients participated in this study. A removable acrylic device was adapted to the molar-premolar region, and commercially pure titanium (control) and zirconium oxide (test) disks were glued to the buccal aspect of each device. The surface roughness of titanium and test specimens was similar. After 24 hours, all disks were removed and processed for scanning electron microscopy, for the evaluation of the portion of surface covered by bacteria. RESULTS: In control specimens, the area covered by bacteria was 19.3% +/- 2.9; in test specimens, the area was 12.1% +/- 1.96. The disk surface covered by bacteria on test specimens was significantly lower than that of control specimens (P = 0.0001). CONCLUSION: Our results demonstrate that zirconium oxide may be a suitable material for manufacturing implant abutments with a low colonization potential.

Adult↗
PubMed2005

Alendronate therapy may be effective in the prevention of bone loss around titanium implants inserted in estrogen-deficient rats.

BACKGROUND: This study evaluated whether alendronate (ALD) influences bone healing around titanium implants inserted in ovariectomized rats and whether it provides a residual effect after its withdrawal. METHODS: Bilateral ovariectomies were performed in 87 Wistar rats and one screw-shaped titanium implant was placed in the tibiae. The animals were divided into the following groups: group SHAM (N = 15): sham surgeries; group OVX (N = 15): ovariectomy; group AT (N = 15): OVX plus alendronate administration for 80 days; group AW (N = 14): OVX plus alendronate administration for 40 days; group ET (N = 14): OVX plus 17beta estradiol administration for 80 days; or group EW (N = 14): OVX plus 17beta estradiol administration for 40 days. Bone-to-implant contact (BIC), bone area (BA) within the limits of implant threads, and bone density in a 500 microm-wide zone lateral to the implant (BD) were obtained and measured for the cortical (zone A) and cancellous (zone B) regions. RESULTS: In zone A, data analysis showed no significant differences among the groups regarding BIC and BD (P >0.05), and a slight beneficial effect of estradiol on BA when compared with the OVX, EW, and AW groups (P <0.05). In zone B, OVX negatively impacted bone healing around the implants, resulting in reduced BA and BD (P<0.05). ALD (continuous/interrupted) and estradiol (only continuous) positively affected BIC, BA, and BD, resulting in values at the same level as the control group (SHAM). CONCLUSIONS: ALD may prevent the negative influence of estrogen deficiency on bone healing around titanium implants inserted in OVX rats. This positive effect, in contrast to estradiol, is sustained following its withdrawal.

Alendronate↗
PubMed2005

Bone filling around titanium implants may benefit from smoking cessation: a histologic study in rats.

BACKGROUND: Although a harmful effect of smoking on titanium implants has been documented, only a few studies have investigated the benefits of smoking cessation. Thus, this study histologically investigated whether smoking cessation influences bone healing around titanium implants and comparatively evaluated temporary versus complete cessation protocols. METHODS: Sixty-six male Wistar rats were randomly assigned to one of four groups: control (N = 16); CSI, intermittent cigarette smoke inhalation (CSI) throughout the entire 150-day experiment (N = 17); P-CSI, CSI 83 days prior to implant placement (N = 17); or R-CSI, CSI for 83 days, cessation 7 days before and 21 weeks after implant placement, and return to CSI for 39 days (N = 16). The animals were sacrificed and the degree of bone-to-implant contact (BIC) and the bone area (BA) within the limits of the implant threads obtained for cortical (zone A) and cancellous bone (zone B). RESULTS: Intergroup analysis (Kruskal-Wallis test, alpha = 0.05) demonstrated a significant effect of CSI on BA (P <0.05) and that temporary or complete CSI cessation protocols resulted in values similar to those of the control group (P >0.05) 88.91% +/- 4.29%; 80.66% +/- 6.55%; 84.27% +/- 6.96%; 85.71% +/- 4.7% in zone A, and 51.28% +/- 6.49%; 38.69% +/- 10.78%; 48.87% +/- 8.47%; 49.47% +/- 8.04%; in zone B for groups CTRL, CSI, P-CSI, and R-CSI, respectively. CONCLUSION: Within the limits of the present investigation, temporary and complete CSI cessation reversed the effect of smoke exposure on bone healing around titanium implants in both cortical and cancellous bone.

Animals↗
PubMed2005

Age-related and surgically induced estrogen deficiencies may differently affect bone around titanium implants in rats.

BACKGROUND: Valuable information has been obtained using the ovariectomy model; however, clinical studies have indicated that such a model may not be appropriate to parallel with the postmenopausal condition and titanium implants. Thus, this study aimed to comparatively evaluate, by histometric analysis, the influence of age-related (ARED) and surgically induced (OVX) estrogen deficiencies on bone around titanium implants inserted in rats. METHODS: Single screw-shaped titanium implants were placed in rat tibiae and animals were then assigned to one of the following groups: SHAM (N = 15): bilateral sham ovariectomies in 90-day-old rats, 21 days before implant placement; OVX (N = 15): bilateral ovariectomies in 90-day-old rats, 21 days before implant placement; and ARED (N = 15): implant placement in reproductive aged rats (22 months old). After 60 days, the animals were sacrificed and undecalcified sections obtained. Bone-to-implant contact (BIC) and bone area (BA) within the limits of implant threads and bone density (BD) in a 500 microm-wide zone lateral to the implant were obtained and arranged for cortical (zone A) and cancellous (zone B) bone regions. RESULTS: For zone A, intergroup analysis showed no significant differences regarding BIC and BA (P >0.05). In contrast, ARED negatively influenced BD around the implants (P <0.05). In zone B, OVX negatively affected BIC and BA (P <0.05), and both ARED and OVX groups demonstrated lower BD than the SHAM group (P <0.05). CONCLUSION: Within the limits of this study, it can be concluded that ARED mainly affects preexisting bone while OVX more significantly affects both newly formed and preexisting bone.

Age Factors↗
PubMed2006

Host response to titanium dental implant placement evaluated in a human oral model.

BACKGROUND: Recent reports have questioned if metal sensitivity may arise from exposure to titanium. The objective of this study was to histologically evaluate non-perforated mucosa covering submerged maxillary titanium implants with regard to induced tissue reactions. METHODS: Thirteen patients, 21 to 69 years of age, without previous implants were included. After initial examination, the bone crest areas destined for dental implant placement were exposed, and threaded external hex dental implants were inserted. Prior to wound closure, a full mucosal tissue slice was biopsied from the edge of the mucoperiosteal flap (baseline). The patients were monitored monthly for 6 months. At the abutment connection, biopsies were taken by a 6-mm punch, altogether yielding 26 specimens. Tissue reactions were analyzed by coded histometric analysis at four defined areas at increasing distance from the oral epithelium, including ratios of inflammatory cells (IC)/epithelial cells, IC/fibroblasts, and number of dense particles. RESULTS: The stained sections portrayed gingival tissue with intact oral epithelium and connective tissue with variable accumulation of IC. Experimental biopsies demonstrated mineralized areas and dense particles of different sizes. Analysis of variance revealed a higher IC/fibroblast ratio for level 3 at baseline compared to level 3 at 6 months (P<0.01). Furthermore, a significant decrease in IC/fibroblast ratio was observed between levels 2 and 3 and 2 and 4 at 6 months (P<0.001). The connective tissue level facing the cover screw contained the highest number of dense particles (P<0.01). CONCLUSIONS: Tissue sensitivity reactions to titanium implants were not disclosed. All 6-month biopsies contained dense particles that were most likely metals.

Adult↗
PubMed2006

Selective cyclooxygenase-2 inhibitor may impair bone healing around titanium implants in rats.

BACKGROUND: The aim of this study was to investigate the effect of a selective cyclooxygenase-2 inhibitor, meloxicam, on bone healing around titanium implants in rats. METHODS: Thirty-one adult male Wistar rats were included in this study, and one screw-shaped titanium implant was inserted in the tibiae of each rat. The animals were randomly assigned to one of the following groups for daily subcutaneous injections: control (N = 14): saline solution; and test (N = 17): 3 mg/kg of meloxicam, each administered daily for 60 days. After the treatment, animals were sacrificed, and undecalcified sections were obtained. Bone-to-implant contact (BIC) and bone area (BA) within the limits of implant threads and bone density (BD) in a 500 mum-wide zone lateral to the implants were obtained and arranged for cortical (zone A) and cancellous (zone B) bone regions. RESULTS: Intergroup comparisons demonstrated that meloxicam significantly reduced bone healing around implants. For zone A, significant differences were observed regarding BIC (47.01 +/- 10.48 A; 35.93 +/- 12.25 B), BA (86.42 +/- 3.66 A; 61.58 +/- 12.09 B), and BD (96.86 +/- 0.96 A; 91.06 +/- 3.05 B) for control and test groups, respectively (P <0.05). For zone B, data analysis also showed significant differences among groups for BIC (30.76 +/- 13.80 A; 16.86 +/- 11.48 B), BA (34.83 +/- 8.18 A; 25.66 +/- 9.16 B), and BD (15.76 +/- 7.05 A; 7.73 +/- 4.61 B) for control and test groups, respectively (P <0.05). CONCLUSION: Meloxicam may negatively influence bone healing in the cortical and cancellous bone around titanium implants inserted in rats after continuous administration.

Animals↗