Effect of Drilling Technique on the Early Integration of Plateau Root Form Endosteal Implants: An Experimental Study in Dogs

Purpose: This study tested the hypothesis that early integration of plateau root form endosseous implants is significantly affected by surgical drilling technique.Materials and Methods: Sixty-four implants were bilaterally placed in the diaphysial radius of 8 beagles and remained 2 and 4 weeks in vivo. Half the implants had an alumina-blasted/acid-etched surface and the other half a surface coated with calcium phosphate. Half the implants with the 2 surface types were drilled at 50 rpm without saline irrigation and the other half were drilled at 900 rpm under abundant irrigation. After euthanasia, the implants in bone were nondecalcified and referred for histologic analysis. Bone-to-implant contact, bone area fraction occupancy, and the distance from the tip of the plateau to pristine cortical bone were measured. Statistical analyses were performed by analysis of variance at a 95% level of significance considering implant surface, time in vivo, and drilling speed as independent variables and bone-to-implant contact, bone area fraction occupancy, and distance from the tip of the plateau to pristine cortical bone as dependent variables.Results: The results showed that both techniques led to implant integration and intimate contact between bone and the 2 implant surfaces. A significant increase in bone-to-implant contact and bone area fraction occupancy was observed as time elapsed at 2 and 4 weeks and for the calcium phosphate-coated implant surface compared with the alumina-blasted/acid-etched surface.Conclusions: Because the surgical drilling technique did not affect the early integration of plateau root form implants, the hypothesis was refuted. (C) 2011 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 69: 2158-2163, 2011

Comparison of crystallinity between natural hydroxyapatite and synthetic cp-Ti /HA coatings

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Desenvolvimento de biocerâmicas porosas de hidroxiapatita para utilização como scaffolds para regeneração óssea

Biocerâmicas porosas tem aplicações biomédicas importantes como preenchimento de defeitos ósseos e scaffolds na engenharia de tecidos. A hidroxiapatita (HA, Ca10(PO4)6(OH)2) que apresenta semelhança química e estrutural com a fase mineral dos ossos e dos dentes, é biocompatível e osteocondutiva, e tem excelente afinidade química e biológica com os tecidos ósseos. Este trabalho teve como objetivo desenvolver biocerâmicas porosas HA para utilização como scaffold para regeneração óssea empregando-se a técnica de réplica da esponja polimérica. A pasta biocerâmica de HA foi obtida por via úmida utilizando hidróxido de cálcio [Ca(OH)2] e ácido fosfórico (H3PO4) e impregnada em esponjas de poliuretano com diferentes densidades. Tratamento térmico a 600°C por 1h foi realizado para eliminação da esponja seguido da sinterização a 1100°C por 2 horas. Os scaffolds apresentaram a HA como fase majoritária, elevada porosidade (> 70%) e poros com tamanhos variando na ordem de macro (>100μm) e microporosidade (1-20μm), sendo estes fatores adequados para a aplicação como scaffolds para regeneração óssea.

Fosfatos de cálcio de interesse biológico: importância como biomateriais, propriedades e métodos de obtenção de recobrimentos

For decades the Hydroxyapatite (HA) was only bioceramic of calcium phosphate system used for bone replacement and regeneration, due to its similarity to the mineral phase of bones and teeth. Because its slow degradation, other calcium phosphate classified as biodegradable started to awaken interest, such as: amorphous calcium phosphate (ACP), octacalcium phosphate (OCP) and tricalcium phosphate (TCP). This work presents the evolution of the use of other calcium phosphates due to their better solubility than the HA, comparing their main physical-chemical and biological properties. Are also presented the main methods used to obtain bioceramic coatings on metal and polymer surfaces.

Biomimetic apatite formation on Ultra-High Molecular Weight Polyethylene (UHMWPE) using modified biomimetic solution

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Synthesis of chitosan/hydroxyapatite membranes coated with hydroxycarbonate apatite for guided tissue regeneration purposes

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Inorganic-Organic Nanocomposite Assembly Using Collagen as a Template and Sodium Tripolyphosphate as a Biomimetic Analog of Matrix Phosphoprotein

Nanocomposites created with polycarboxylic acid alone as a stabilization agent for prenucleation clusters-derived amorphous calcium phosphate exhibit nonperiodic apatite deposition. In the present study, we report the use of inorganic polyphosphate as a biomimetic analog of matrix phosphoprotein for directing poly(acrylic acid)-stabilized amorphous nano-precursor phases to assemble into periodic apatite-collagen nanocomposites. The sorption and desorption characteristics of sodium tripolyphosphate to type I collagen were examined. Periodic nanocomposite assembly with collagen as a template was demonstrated with TEM and SEM using a Portland cement-based resin composite and a phosphate-containing simulated body fluid. Apatite was detected within the collagen at 24 h and became more distinct at 48 h, with prenucleation clusters attaching to the collagen fibril surface during the initial infiltration stage. Apatite-collagen nanocomposites at 72 h were heavily mineralized with periodically arranged intrafibrillar apatite platelets. Defect-containing nanocomposites caused by desorption of TPP from collagen fibrils were observed in regions lacking the inorganic phase.

Development, characterization and clinical use of a biodegradable composite scaffold for bone engineering in oro-maxillo-facial surgery

We have developed a biodegradable composite scaffold for bone tissue engineering applications with a pore size and interconnecting macroporosity similar to those of human trabecular bone. The scaffold is fabricated by a process of particle leaching and phase inversion from poly(lactide-co-glycolide) (PLGA) and two calcium phosphate (CaP) phases both of which are resorbable by osteoclasts; the first a particulate within the polymer structure and the second a thin ubiquitous coating. The 3-5 mu m thick osteoconductive surface CaP abrogates the putative foreign body giant cell response to the underlying polymer, while the internal CaP phase provides dimensional stability in an otherwise highly compliant structure. The scaffold may be used as a biomaterial alone, as a carrier for cells or a three-phase drug delivery device. Due to the highly interconnected macroporosity ranging from 81% to 91%, with macropores of 0.8 similar to 1.8 mm, and an ability to wick up blood, the scaffold acts as both a clot-retention device and an osteoconductive support for host bone growth. As a cell delivery vehicle, the scaffold can be first seeded with human mesenchymal cells which can then contribute to bone formation in orthotopic implantation sites, as we show in immune-compromised animal hosts. We have also employed this scaffold in both lithomorph and particulate forms in human patients to maintain alveolar bone height following tooth extraction, and augment alveolar bone height through standard sinus lift approaches. We provide a clinical case report of both of these applications; and we show that the scaffold served to regenerate sufficient bone tissue in the wound site to provide a sound foundation for dental implant placement. At the time of writing, such implants have been in occlusal function for periods of up to 3 years in sites regenerated through the use of the scaffold.

Hydroxylapatite implants with or without collagen in the zygomatic arch of rats. Histological study.

The authors studied the behavior of calcium phosphate materials used as inlay implants into bone cavities prepared in the zygomatic arch of rats. Fifty male albino rats were divided into four groups as follows: group I-preparation of bone cavities which did not receive any implant material as controls; group II-implants of Interpore 200; group III-implants of experimental hydroxylapatite; group IV-implants of experimental hydroxylapatite combined with collagen. The animals were sacrificed after 5, 15, 30, 60 and 120 days and the specimens were submitted to histological analysis. Results showed that the experimental hydroxylapatite used in group III presented better osteogenic properties compared to the other materials. All tested materials were biocompatible, although group IV presented a more intense inflammatory response.

Comparative therapeutic use of Risedronate and Calcarea phosphorica - Allopathy versus homeopathy - In bone repair in castrated rats

Osteoporosis, a disease characterized by progressive bone loss, has been the target of several studies in the past few years. It results in a much higher risk for fractures and might cause slower bone lesion healing. The aim of this work was to study the effects of Risedronate (allopathic medicine) and Calcarea phosphorica 6CH (homeopathic medicine) on the repair of bone lesions in male rats with osteoporosis induced by castration. Eighty-four three-month-old rats were used divided into four groups of twenty-one animals each. Three groups where castrated and one group was submitted to Sham surgery. One month later, cortical lesions were made in all animals' tibiae and, after one day, the different experimental treatments began according to the following groups: CR - castrated/Risedronate (1 mg/kg/day); CCp - castrated/ Calcarea phosphorica 6CH (3 drops/day); CP - castrated/placebo and SP - Sham/placebo. The animals were sacrificed at seven, fourteen and twenty-eight days after the beginning of the treatments and had their tibiae removed. Digital radiographs of the tibiae were taken and analyzed in order to evaluate the optical density of the defect area. Then, they were decalcified and processed for histological and histomorphometrical analysis. The data were submitted to ANOVA, and to the Tukey and Dunnett tests (5%). The allopathic and homeopathic treatments led to different bone formation as regards remodeling and maturation aspects. Further research is necessary to access the resistance and quality of the newly formed bone.

Estudo da influência dos íons K+, Mg2+, SO4 2- e CO3 2- na cristalização biomimética de fosfato de cálcio amorfo (ACP) e conversão a fosfato octacálcico (OCP)

The crystallization of hydroxyapatite (HA) in aqueous solution can be described by the mechanism ACP → OCP → HA. In this work, it was studied the influence of K+, Mg2+, SO4 2- AND CO3 2- ions in the formation of ACP and in its conversion to OCP, using biomimetic coatings on metallic substrates of commercially pure titanium (Ti c.p.). The results showed that Mg2+ and CO3 2- ions favored both the formation of ACP and its conversion to OCP. Differently, K+ and SO4 2- ions did not influence the formation of ACP and, consequently, interfered in the conversion to OCP.

Efeito de níveis de fósforo no crescimento inicial, biomassa e atividade in vivo da fosfatase ácida em Lychnophora ericoides Mart

The effect of phosphorus levels on seedling growth, dry and fresh matter production, and in vivo acid phosphatase activity was studied in Lychnophora ericoides cultivated during 130 days after transplanting in a greenhouse. Experimental design was completely randomized, with four P 2O 5 levels (0; 40; 80; 160 mg dm -3 as triple superphosphate) and five replicates of four plants each. The used soil was dystrophic acid dark red latosol. Lychnophora ericoides is responsive to phosphate fertilization with modification in daily relative growth rate, dry matter production and distribution among the plant parts. Acid phosphatase activity had significant and negative correlation with total, leaf and stem dry matter production, as well as with P levels accumulated in the leaf tissue. On the other hand, acid phosphatase activity had significant and positive correlation with root/shoot ratio.

Effect of bleaching on sound enamel and with early artificial caries lesions using confocal laser microscopy

The aim of this study was to evaluate effect of bleaching agents on sound enamel (SE) and enamel with early artificial caries lesions (CL) using confocal laser scanning microscopy (CLSM). Eighty blocks (4 × 5 × 5 mm) of bovine enamel were used and half of them were submitted to a pH cycling model to induce CL. Eight experimental groups were obtained from the treatments and mineralization level of the enamel (SE or CL) (n=10). SE groups: G1 - unbleached (control); G2 - 4% hydrogen peroxide (4 HP); G3 - 4 HP containing 0.05% Ca (Ca); G4 - 7.5% hydrogen peroxide (7.5 HP) containing amorphous calcium phosphate (ACP). CL groups: G5 - unbleached; G6 - 4 HP; G7 - 4 HP containing Ca; G8 - 7.5 HP ACP. G2, G3, G6, G7 were treated with the bleaching agents for 8 h/day during 14 days, while G4 and G8 were exposed to the bleaching agents for 30 min twice a day during 14 days. The enamel blocks were stained with 0.1 mM rhodamine B solution and the demineralization was quantified using fluorescence intensity detected by CLSM. Data were analyzed using ANOVA and Fisher's tests (α=0.05). For the SE groups, the bleaching treatments increased significantly the demineralization area when compared with the unbleached group. In the CL groups, no statistically significant difference was observed (p>0.05). The addition of ACP or Ca in the composition of the whitening products did not overcome the effects caused by bleaching treatments on SE and neither was able to promote remineralization of CL.

Osseointegration assessment of chairside argon-based nonthermal plasma-treated Ca-P coated dental implants

This study investigated the effect of an Argon-based nonthermal plasma (NTP) surface treatment-operated chairside at atmospheric pressure conditions applied immediately prior to dental implant placement in a canine model. Surfaces investigated comprised: Calcium-Phosphate (CaP) and CaP + NTP (CaP-Plasma). Surface energy was characterized by the Owens-Wendt-Rabel-Kaelble method and chemistry by X-ray photoelectron spectroscopy (XPS). Six adult beagles dogs received 2 plateau-root form implants (n = 1 each surface) in each radii, providing implants that remained 1 and 3 weeks in vivo. Histometric parameters assessed were bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO). Statistical analysis was performed by Kruskall-Wallis (95% level of significance) and Dunn's post-hoc test. The XPS analysis showed peaks of Ca, C, O, and P for the CaP and CaP-Plasma surfaces. Both surfaces presented carbon primarily as hydro-carbon (CAC, CAH) with lower levels of oxidized carbon forms. The CaP surface presented atomic percent values of 38, 42, 11, and 7 for C, O, Ca, and P, respectively, and the CaPPlasma presented increases in O, Ca, and P atomic percent levels at 53, 12, and 13, respectively, in addition to a decrease in C content at 18 atomic percent. At 1 week no difference was found in histometric parameters between groups. At 3 weeks significantly higher BIC and BAFO were observed for CaPPlasma treated surfaces. Surface elemental chemistry was modified by the Ar-based NTP. Ar-based NTP improved bone formation around plateau-root form implants at 3 weeks compared with CaP treatment alone. © 2012 Wiley Periodicals, Inc.

Analysis of the bioactive surface of Ti-35Nb-7Zr alloy after alkaline treatment and solution body fluid

The purpose of this work was to evaluate the Ti-35Nb-7Zr experimental alloy after surface treatment and soaking in solution body fluid (SBF) to form bonelike apatite. The Ti-35Nb-7Zr alloy was produced from commercially pure materials (Ti, Nb and Zr) by an arc melting furnace. All ingots were submitted to sequences of heat treatment (1100 °C/2 h and water quenching), cold working by swaging procedures and heat treatment (1100 °C/2 h and water quenching). Discs with 13 mm diameter and 3 mm in thickness were cut. The samples were immersed in NaOH aqueous solution with 5 M at 60 °C for 72 h, washed with distilled water and dried at 40 °C for 24 h. After the alkaline treatment, samples were heat treated in both conditions: at 450 and 600 °C for 1 h in an electrical furnace in air. Then, they were soaking in SBF for 24 h to form an apatite layer on the surface. The surfaces were investigated by using scanning electron microscope (SEM), energy dispersive X-ray spectroscopy (EDX), infrared spectroscopy (FTIR) and contact angle measurements. The results indicate that calcium phosphate could form on surface of Ti-35Nb-7Zr experimental alloy. © Springer-Verlag Berlin Heidelberg 2013.