Effect of phosphate-bonded investments on titanium reaction layer and crown fit

This study analyzed the reaction layer and measured the marginal crown fit of cast titanium applied to different phosphate-bonded investments, prepared under the following conditions (liquid concentration/casting temperature): Rema Exakt (RE) - 100%/237°C, 75%/287°C, Castorit Super C (CS)-100%/70°C, 75%/141°C and Rematitan Plus (RP)-100%/430°C (special to titanium cast, as the control group). The reaction layer was studied using the Vickers hardness test, and analyzed by two way ANOVA and Tukey's HSD tests (α = 0.05). Digital photographs were taken of the crowns seated on the die, the misfit was measured using an image analysis system and One-way ANOVA, and Tukey's test was applied (α = 0.05). The hardness decreased from the surface (601.17 VHN) to 150 μm (204.03 VHN). The group CS 75%/141°C presented higher hardness than the other groups, revealing higher surface contamination, but there were no differences among the groups at measurements deeper than 150 μm. The castings made with CS - 100%/70°C presented the lowest levels of marginal misfit, followed by RE -100%/237°C. The conventional investments CS (100%) and RE (100%) showed better marginal fit than RP, but the CS (75%) had higher surface contamination.

Effect of surface treatments on the bond strength of a resin cement to commercially pure titanium

Investigation of the effectiveness of surface treatments that promote a strong bond strength of resin cements to metals can contribute significantly to the longevity of metal-ceramic restorations. This study evaluated the effect of surface treatments on the shear bond strength (SBS) of a resin cement to commercially pure titanium (CP Ti). Ninety cast CP Ti discs were divided into 3 groups (n=30), which received one of the following airborne-particle abrasion conditions: (1) 50 μm Al2O3 particles; (2) 30 μm silica-modified Al2O3 particles (Cojet Sand); (3) 110 μm silica-modified Al2O3 particles (Rocatec). For each airborne-particle abrasion condition, the following post-airborne-particle abrasion treatments were used (n=10): (1) none; (2) adhesive Adper Single Bond 2; (3) silane RelyX Ceramic Primer. RelyX ARC resin cement was bonded to CP Ti surfaces. All specimens were thermally cycled before being tested in shear mode. Failure mode was determined. The best association was Rocatec plus silane. All groups showed 100% adhesive failure. There were combinations that promote higher SBS than the protocol recommended by the manufacturer of RelyX ARC.

Evaluation of bone ingrowth into porous titanium implant: Histomorphometric analysis in rabbits

A porous material for bone ingrowth with adequate pore structure and appropriate mechanical properties has long been sought as the ideal bone-implant interface. This study aimed to assess in vivo the influence of three types of porous titanium implant on the new bone ingrowth. The implants were produced by means of a powder metallurgy technique with different porosities and pore sizes: Group 1 = 30% and 180 μm; Group 2 = 30% and 300 μm; and Group 3 = 40% and 180 μm. Six rabbits received one implant of each type in the right and left tibiae and were sacrificed 8 weeks after surgery for histological and histomor-phometric analyses. Histological analysis confirmed new bone in contact with the implant, formed in direction of pores. Histomorphometric evaluation demonstrated that the new bone formation was statistically significantly lower in the group G1 than in group G3, (P = 0.023). Based on these results, increased porosity and pore size were concluded to have a positive effect on the amount of bone ingrowth.

Retention strength of cobalt-chromium vs nickel-chromium titanium vs Cp titanium in a cast framework association of removable partial overdenture

Aim: There is little information considering the framework association between cast clasps and attachments. The aim of this study was to evaluate the retention strength of frameworks match circumferential clasps and extra resilient attachment cast in three different alloys (cobalt-chromium, nickel-chromium titanium and commercially pure titanium), using two undercut (0.25 and 0.75 mm) and considering different period of time (0, 1/2, 1, 2, 3, 4 and 5 years). Methods: Using two metallic matrices, representing a partially edentulous mandibular right hemiarch with the first molar crown, canine root and without premolars, 60 frameworks were fabricated. Three groups (n = 20) of each metal were cast and each group was divided into two subgroups (n = 10), corresponding the molar undercut of 0.25 mm and 0.75 mm. The nylon male was positioned at the matrix and attached to the acrylic resin of the prosthetic base. The samples were subjected to an insertion and removal test under artificial saliva environment. Results: The data were analyzed and compared with ANOVAs and Tukey's test at 95% of probability. The groups cast in cobaltchromium and nickel-chromium-titanium had the highest mean retention strength (5.58 N and 6.36 N respectively) without significant difference between them, but statistically different from the group cast in commercially pure titanium, which had the lowest mean retention strength in all the periods (3.46 N). The association frameworks using nickel-chromium-titanium and cobalt-chromium could be used with 0.25 mm and 0.75 mm of undercut, but the titanium samples seems to decrease the retention strength, mainly in the 0.75 mm undercut. The circumferential clasps cast in commercially pure titanium used in 0.75 mm undercuts have a potential risk of fractures, especially after the 2nd year of use. Conclusion: This in vitro study showed that the framework association between cast clasp and an extra resilient attachment are suitable to the three metals evaluated, but strongly suggest extra care with commercially pure titanium in undercut of 0.75 mm. Clinical significance: Frameworks fabricated in Cp Ti tend to decrease in retentive strength over time and have a potential risk of fracture in less than 0.75 mm of undercut.

Cyclosporine-a and bone density around titanium implants: A histometric study in rabbits

Aim: Cyclosporine A (CsA) is an immunosuppressive agent commonly used to prevent organ transplantation rejection. It has been demonstrated that CsA may negatively affect osseointegration around dental implants. Therefore, the aim of this study was to evaluate the effect of CsA administration on bone density around titanium dental implants. Materials and Methods: Fourteen New Zealand rabbits were randomly divided into 2 groups with seven animals each. The test group (CsA) received daily subcutaneous injection of CsA (10mg/kg body weight) and the control group (CTL) received saline solution by the same route of administration. Three days after the beginning of immunosuppressive therapy, one machined dental implant (7.00 mm in lenght and 3.75 mm in diameter) was inserted bilaterally at the region of the tibial methaphysis. After 4 and 8 weeks the animals were sacrificed and the histometrical procedures were performed to analyse the bone density around the first four threads of the coronal part of the implant. Results: A significant increase in the bone density was observed from the 4- to the 8 week-period in the control group (37.41% + 14.85 versus 58.23% + 16.38 - p <0.01). In contrast, bone density consistently decreased in the test group overtime (46.31% + 17.38 versus 16.28 + 5.08 - p <0.05). In the 8-week period, there was a significant difference in bone density between the control and the test groups (58.23 + 16.38 eand16.28 + 5.08 - p= 0.001). Conclusion: Within the limits of this study, long-term CsA administration may reduce bone density around titanium dental implants during the osseointegration process.

Flexibility and torsional resistance of three nickel-titanium retreatment instrument systems

Aim To assess the dimensional characteristics, flexibility and torsional behaviour of nickel-titanium retreatment instruments. Methodology Using image analysis software and high-resolution digital images, the instrument length, tip angle, diameter at 3mm from the tip and the distance between the blades (pitch length) of the following eight instruments were measured (n=12 for each measurement parameter): the ProTaper Universal retreatment (PTU-R) D1, D2 and D3 instruments; the R-Endo R1, R2 and R3 retreatment instruments; and the Mtwo retreatment (Mtwo-R) sizes 25 and 15 retreatment instruments. Maximum torque and the angular deflection at fracture as well as the bending moment at 45° were measured (n=12) according to the International Standards Organisation (ISO) specification number 3630-1. Data were analysed using the analysis of variance (α=0.05). Results The length of the active part of the instruments was found to vary according to the depth of the canal into which they were designed to reach. The pitch length also increased along the active length. The PTU-R D1 and the Mtwo-R instruments had active tips. Measurements of the bending moment at 45° revealed that the Mtwo-R 15 instrument was the most flexible, whereas the PTU-R D1 was the least flexible. The maximum torque tended to increase as the instrument diameter at 3mm from the tip increased, whereas the angular deflection at fracture varied in the opposite direction. Conclusions The geometrical characteristics of the retreatment instruments and their flexibility and torsion behaviour were consistent with their intended clinical application. © 2011 International Endodontic Journal.

Shellac and hydroxyapatitte coatings on titanium niobium and AISI 316L steel surfaces produced by dip-coating

Shellac is a natural resin used for the preservation of fruits, bones and as a coating on drugs. The hydroxyapatite (HA), which is naturally found in human bones, is used as filler to substitute amputated bone or as a coating for prosthetics, promoting bone growth in implants of prostheses. The objective of this work is to immobilize HA from an alcoholic solution of shellac on plates of titanium, niobium and AISI 316L steel using the simple dip-coating method. The corrosion resistance of the uncoated films is compared with ones coated with shellac and shellac plus HA. The deterioration of the film composed of shellac with hydroxyapatite in saline solution follows the ascending order: AISI 316L steel, titanium, niobium. The elemental analysis of the shellac showed that it mainly consists of the elements C, H, N and O. We used the FT-IR spectrum to characterize the shellac and HA. ©The Electrochemical Society.

Rough turning of titanium alloy (6Al-4V)

Metal machining is the complex process due the used cutting parameters. In metal cutting process, materials of workpiece differ widely in their ability to deform plastically, to fracture and to sustain tensile stresses. Moreover, the material involved in the process has a great influence in these operations. The Ti-6Al-4V alloy is very used in the aeronautical industry, mainly in the manufacture of engines, has very important properties such the mechanical and corrosion resistance in high te mperatures. The turning of the Ti-Al-4V alloy is very difficult due the rapid tool wear. Such behavior result of the its low thermal conductivity in addition the high reactivity with the cutting tool. The formed chip is segmented and regions of the large deformation named shear bands plows formed. The machinability of the cutting process can be evaluated by several measures including power consume, machined surface quality, tool wear, tool life, microstructure and morphology of the obtained chip. This paper studies the effect of cutting parameters, speed and feed rates, in the tool wear and chip properties using uncoating cemented carbide tool. Microe-structural characterization of the chip and tool wear was performed using scanning electron microscopy (SEM) and Light Optical Mcroscopy (LOM).

Biomechanical effect of one session of low-level laser on the bone-titanium implant interface

Low-level laser (LLL) has been used on peri-implant tissues for accelerating bone formation. However, the effect of one session of LLL in the strength of bone-implant interface during early healing process remains unclear. The present study aims to evaluate the removal torque of titanium implants irradiated with LLL during surgical preparation of implant bed, in comparison to non-irradiation. Sixty-four Wistar rats were used. Half of the animals were included in LLL group, while the other half remained as control. All animals had the tibia prepared with a 2 mm drill, and a titanium implant (2.2 × 4 mm) was inserted. Animals from LLL group were irradiated with laser (gallium aluminum arsenide), with a wavelength of 808 nm, a measured power output of 50 mW, to emit radiation in collimated beams (0.4 cm2), for 1 min and 23 s, and an energy density of 11 J/cm2. Two applications (22 J/cm 2) were performed immediately after bed preparation for implant installation. Flaps were sutured, and animals from both groups were sacrificed 7, 15, 30, and 45 days after implant installation, when load necessary for removing implant from bone was evaluated by using a torquimeter. In both groups, torque values tended to increase overtime; and at 30 and 45 days periods, values were statistically higher for LLL group in comparison to control (ANOVA test, p < 0.0001). Thus, it could be suggested that a single session of irradiation with LLL was beneficial to improve bone-implant interface strength, contributing to the osseointegration process. © 2012 Springer-Verlag London Ltd.

Bone-healing pattern at the surface of titanium implants: An experimental study in the dog

Objective: To study the early sequential stages of osseointegration at implants installed in alveolar bony. Materials and methods: In 12 Labrador dogs, all mandibular premolars and first molars were extracted bilaterally. After 3 months of healing, full-thickness flaps were elevated in the edentulous region of the right side of the mandible. Implants were installed, and the flaps were sutured to allow a fully submerged healing. The timing of the installations in the left side of the mandible and of sacrifices were performed with a schedule that various observation periods to sacrifice from 5, 10, 20, and 30 days were available so that n = 6 was obtained per each healing period. Ground sections were prepared and analyzed. Results: Newly formed bone in contact with the implant surface was found after 10 days of healing and the percentage increased up to 50% after 1 month of healing. A higher percentage was found in the trabecular compared with the cortical bony compartment. Old bone decreased by about 50% during healing, being still present after 1 month (16%). The proportions of bone debris and bone particles were at 27% after 5 days and decreased during healing to 6% after 1 month. Conclusion: Osseointegration (new bone-to-implant contact) developed at various rates for cortical and trabecular compartments, respectively. In the trabecular region, mesenchymal cells were identified, subsequently developing into new bone in contact with the implant surface. In the cortical compartment, however, resorptive processes were observed throughout all periods of healing. The proportion of newly formed bone percentage was lower compared with that of the trabecular area. Old bone was still present after 1 month of healing in both compartments. Bone debris and small bone particles appeared to be involved in initial bone formation. © 2013 John Wiley & Sons A/S.

Bone healing around titanium implants in two rat colitis models

Objective: Crohn's disease is a chronic inflammatory process that has recently been associated with a higher risk of early implant failure. Herein we provide information on the impact of colitis on peri-implant bone formation using preclinical models of chemically induced colitis. Methods: Colitis was induced by intrarectal instillation of 2,4,6-trinitro-benzene-sulfonic-acid (TNBS). Colitis was also induced by feeding rats dextran-sodium-sulfate (DSS) in drinking water. One week after disease induction, titanium miniscrews were inserted into the tibia. Four weeks after implantation, peri-implant bone volume per tissue volume (BV/TV) and bone-to-implant contacts (BIC) were determined by histomorphometric analysis. Results: Cortical histomorphometric parameters were similar in the control (n = 10), DSS (n = 10) and TNBS (n = 8) groups. Cortical BV/TV was 92.2 ± 3.7%, 92.0 ± 3.0% and 92.6 ± 2.7%. Cortical BIC was 81.3 ± 8.8%, 83.2 ± 8.4% and 84.0 ± 7.0%, respectively. No significant differences were observed when comparing the medullary BV/TV and BIC (19.5 ± 6.4%, 16.2 ± 5.6% and 15.4 ± 9.0%) and (48.8 ± 12.9%, 49.2 ± 6.2 and 41.9 ± 11.7%), respectively. Successful induction of colitis was confirmed by loss of body weight and colon morphology. Conclusions: The results suggest bone regeneration around implants is not impaired in chemically induced colitis models. Considering that Crohn's disease can affect any part of the gastrointestinal tract including the mouth, our model only partially reflects the clinical situation. © 2012 John Wiley & Sons A/S.

Reduced in vitro immune response on titania nanotube arrays compared to titanium surface

Material surfaces that provide biomimetic cues, such as nanoscale architectures, have been shown to alter cell/biomaterial interactions. Recent studies have identified titania nanotube arrays as strong candidates for use in interfaces on implantable devices due to their ability to elicit improved cellular functionality. However, limited information exists regarding the immune response of nanotube arrays. Thus, in this study, we have investigated the short- and long-term immune cell reaction of titania nanotube arrays. Whole blood lysate (containing leukocytes, thrombocytes and trace amounts of erythrocytes), isolated from human blood, were cultured on titania nanotube arrays and biomedical grade titanium (as a control) for 2 hours and 2 and 7 days. In order to determine the in vitro immune response on titania nanotube arrays, immune cell functionality was evaluated by cellular viability, adhesion, proliferation, morphology, cytokine/chemokine expression, with and without lipopolysaccharide (LPS), and nitric oxide release. The results presented in this study indicate a decrease in short- and long-term monocyte, macrophage and neutrophil functionality on titania nanotube arrays as compared to the control substrate. This work shows a reduced stimulation of the immune response on titania nanotube arrays, identifying this specific nanoarchitecture as a potentially optimal interface for implantable biomedical devices. © 2013 The Royal Society of Chemistry.

Effects of Chronic Stress and Alendronate Therapy on the Osseointegration of Titanium Implants

Purposes: The purposes of this study were to evaluate the influence of chronic stress (CS) on implant osseointegration and also to analyze whether alendronate (ALN) therapy could prevent these eventual stress-negative effects. Materials and Methods: Adult male Holtzmann rats were assigned to one of the four experimental groups: AL (ALN; 1mg/kg/week; n=12), ALS (ALN+CS; 1mg/kg/week; n=12), CTL (sterile physiological saline; n=12), or CTLS (sterile physiological saline+CS; n=12). After 58 days of drug therapy, the ALS and CTLS groups were exposed to CS, and 2 days later all animals underwent tibial implant installation. The animals were euthanized 28 days following the operative surgical procedure. Results: It was observed that the CTLS group presented an impairment of bone metabolism represented by lowest levels of bone-specific alkaline phosphatase and bone area fraction occupancy values. Furthermore, these animals presented a higher proportion of empty osteocytic lacunae. In contrast, the ALN therapy showed increased osseointegration and torque value parameters, regardless of stress exposition. Conclusions: Analysis of the data presented suggests that CS partially impairs the osseointegration of tibial implants and that ALN therapy is able to prevent these negative effects. © 2013 Wiley Periodicals, Inc.

Mechanical Property Assessment of Bone Healing around a Titanium-Zirconium Alloy Dental Implant

Background: It has been reported that titanium-zirconium alloy with 13-17% zirconium (TiZr1317) implants show higher biomechanical stability and bone area percentage relative to commercially pure titanium (cpTi) grade 4 fixtures. Purpose: This study aimed to determine whether the higher stability for TiZr1317 implants is associated with higher mechanical properties of remodeling bone in the areas around the implants. Materials and Methods: This study utilized 36 implants (n=18: TiZr1317, n=18: cpTi), which were placed in the healed ridges of the mandibular premolar and first molar of 12 mini pigs (n=3 implants/animal). After 4 weeks in vivo, the samples were retrieved, and resin-embedded histologic sections of approximately 100μm in thickness were prepared. In order to determine the nanomechanical properties, nanoindentation (n=30 tests/specimen) was performed on the bone tissue of the sections under wet conditions with maximum load of 300μN (loading rate: 60μN/s). Results: The mean (±standard deviation) elastic modulus (E) and hardness (H) for the TiZr1317 group were 2.73±0.50GPa and 0.116±0.017GPa, respectively. For the cpTi group, values were 2.68±0.51GPa and 0.110±0.017GPa for E and H, respectively. Although slightly higher mechanical properties values were observed for the TiZr1317 implants relative to the cpTi for both elastic modulus and hardness, these differences were not significant (E=p>0.75; H=p>0.59). Conclusions: The titanium-zirconium alloy used in this study presented similar degrees of nanomechanical properties to that of the cpTi implants. © 2013 Wiley Periodicals, Inc.

Osteogenesis-inducing calcium phosphate nanoparticle precursors applied to titanium surfaces

This study investigated the effects of the morphology and physicochemical properties of calcium phosphate (CaP) nanoparticles on osteogenesis. Two types of CaP nanoparticles were compared, namely amorphous calcium phosphate (ACP) nano-spheres (diameter: 9-13 nm) and poorly crystalline apatite (PCA) nano-needles (30-50 nm x 2-4 nm) that closely resemble bone apatite. CaP particles were spin-coated onto titanium discs and implants; they were evaluated in cultured mouse calvarial osteoblasts, as well as after implantation in rabbit femurs. A significant dependence of CaP coatings was observed in osteoblast-related gene expression (Runx2, Col1a1 and Spp1). Specifically, the PCA group presented an up-regulation of the osteospecific genes, while the ACP group suppressed the Runx2 and Col1a1 expression when compared to blank titanium substrates. Both the ACP and PCA groups presented a more than three-fold increase of calcium deposition, as suggested by Alizarin red staining. The removal torque results implied a slight tendency in favour of the PCA group. Different forms of CaP nanostructures presented different biologic differences; the obtained information can be used to optimize surface coatings on biomaterials. © 2013 IOP Publishing Ltd.