Retrospective Clinical Study of 988 Dual Acid-Etched Implants Placed in Grafted and Native Bone for Single-Tooth Replacement

Purpose: To evaluate the influence of sex, implant characteristics, and bone grafting on the survival rate of dual acid-etched (DAE) implants. Materials and Methods: Patients treated with internal-hex DAE implants for single-tooth replacement in a military dental clinic between January 2005 and December 2010 were included in this study. Clinical data related to implant characteristics, implant location, presence of grafted bone, and implant failures were collected. The primary outcome was implant loss. The survival rate was analyzed using the Kaplan-Meier method. Cox regression modeling was used to determine which factors would predict implant failure. Results: DAE implants were evaluated in a total of 988 patients (80.3% men). Twenty-four (2.4%) implants failed, most were cylindric (54.2%) with regular platforms (70.8%) and were 10 mm long (58.3%). The failure rate was 2.4% for the anterior maxilla, 3.3% for the posterior maxilla, 1.6% for the anterior mandible, and 2.0% for posterior mandible. The cumulative survival rate was 97.6%. The failure rate was 8.8% in implants placed after sinus augmentation, 7.3% in bone block-grafted areas, and 1.6% in native bone. Based on multivariable analysis (Cox regression), sinus augmentation and bone block grafting had a statistically significant effect on implant failure; the hazard ratios were 5.5 and 4.6, respectively. Conclusion: The results revealed that DAE implants had high survival rates, and no influence of sex, location, shape, diameter, or length on failure rates could be observed. However, a significant association was observed between failure and presence of bone graft in the implant area. Int J Oral Maxillofac Implants 2012;27:1243-1248

Bone-implant interface. Evaluation of osteoblastic cells behavior on nanopatterned titanium surfaces: an in vitro analysis

Protein-adsorption occurs immediately following implantation of biomaterials. It is unknown at which extent protein-adsorption impacts the cellular events at bone-implant interface. To investigate this question, we compared the in-vitro outcome of osteoblastic cells grown onto titanium substrates and glass as control, by modulating the exposure to serum-derived proteins. Substrates consisted of 1) polished titanium disks; 2) polished disks nanotextured with H2SO4/H2O2; 3) glass. In the pre-adsorption phase, substrates were treated for 1h with αMEM alone (M-noFBS) or supplemented with 10%-foetal-bovine-serum (M-FBS). MC3T3-osteoblastic-cells were cultured on the pre-treated substrates for 3h and 24h, in M-noFBS and M-FBS. Subsequently, the culture medium was replaced with M-FBS and cultures maintained for 3 and 7days. Cell-number was evaluated by: Alamar-Blue and MTT assay. Mitotic- and osteogenic-activities were evaluated through fluorescence-optical-microscope by immunolabeling for Ki-67 nuclear-protein and Osteopontin. Cellular morphology was evaluated by SEM-imaging. Data were statistically analyzed using ANOVA-test, (p<0.05). At day3 and day7, the presence or absence of serum-derived proteins during the pre-adsorption phase had not significant effect on cell-number. Only the absence of FBS during 24h of culture significantly affected cell-number (p<0.0001). Titanium surfaces performed better than glass, (p<0.01). The growth rate of cells between day3 and 7 was not affected by the initial absence of FBS. Immunolabeling for Ki-67 and Osteopontin showed that the mitotic- and osteogenic- activity were ongoing at 72h. SEM-analysis revealed that the absence of FBS had no major influence on cell-shape. • Physico-chemical interactions without mediation by proteins are sufficient to sustain the initial phase of culture and guide osteogenic-cells toward differentiation. • The challenge is avoiding adsorption of ‘undesirables’ molecules that negatively impact on the cueing cells receive from surface. This may not be a problem in healthy patients, but may have an important role in medically-compromised-individuals in whom the composition of tissue-fluids is altered.

Early loading of nonsubmerged titanium implants with a chemically modified sand-blasted and acid-etched surface: 6-month results of a prospective case series study in the posterior mandible focusing on peri-implant crestal bone changes and implant stability quotient (ISQ) values

PURPOSE: The aim of this prospective case series study was to evaluate the short-term success rates of titanium screw-type implants with a chemically modified sand-blasted and acid-etched (mod SLA) surface after 3 weeks of healing. MATERIAL AND METHODS: A total of 56 implants were inserted in the posterior mandible of 40 partially edentulous patients exhibiting bone densities of class I to III. After a healing period of 3 weeks, all implants were functionally loaded with a screw-retained crown or fixed dental prosthesis. The patients were recalled at weeks 4, 7, 12, and 26 for monitoring and assessment of clinical and radiological parameters, including implant stability quotient (ISQ) measurements. RESULTS: None of the implants failed to integrate. However, two implants were considered "spinners" at day 21 and left unloaded for an extended period. Therefore, 96.4% of the inserted implants were loaded according to the protocol tested. All 56 implants including the "spinners" showed favorable clinical and radiographic findings at the 6-month follow-up examination. The ISQ values increased steadily throughout the follow-up period. At the time of implant placement, the range of ISQ values exhibited a mean of 74.33, and by week 26, a mean value of 83.82 was recorded. Based on strict criteria, all 56 implants were considered successfully integrated, resulting in a 6-month survival and success rate of 100.0%. CONCLUSION: This prospective study using an early-loading protocol after 3 weeks of healing demonstrated that titanium implants with the modified SLA surface can achieve and maintain successful tissue integration over a period of at least 6 months. The ISQ method seems feasible to monitor implant stability during the initial wound-healing period.

Controlling whole blood activation and resultant clot properties on various material surfaces : a possible therapeutic approach for enhancing bone healing

Injured bone initiates the healing process by forming a blood clot at the damaged site. However, in severe damage, synthetic bone implants are used to provide structural integrity and restore the healing process. The implant unavoidably comes into direct contact with whole blood, leading to a blood clot formation on its surface. Despite this, most research in bone tissue engineering virtually ignores the important role of a blood clot in supporting healing. Surface chemistry of a biomaterial is a crucial property in mediating blood-biomaterials interactions, and hence the formation of the resultant blood clot. Surfaces presenting mixtures of functional groups carboxyl (–COOH) and methyl (–CH3) have been shown to enhance platelet response and coagulation activation, leading to the formation of fibrin fibres. In addition, it has been shown that varying the compositions of these functional groups and the length of alkyl groups further modulate the immune complement response. In this study, we hypothesised that a biomaterial surface with mixture of –COOH/–CH3(methyl), –CH2CH3 (ethyl) or –(CH2)3CH3 (butyl) groups at different ratios would modulate blood coagulation and complement activation, and eventually tailor the structural and functional properties of the blood clot formed on the surface, which subsequently impacts new bone formation. Firstly, we synthesised a series of materials composed of acrylic acid (AA), and methyl (MMA), ethyl (EMA) or butyl methacrylates (BMA) at different ratios and coated on the inner surfaces of incubation vials. Our surface analysis showed that the amount of –COOH groups on the surface coatings was lower than the ratios of AA prepared in the materials even though the surface content of –COOH groups increased with increasing in AA ratios. It was indicated that the surface hydrophobicity increased with increasing alkyl chain length: –CH 3 > –CH2CH3 > –(CH2)3CH3, and decreased with increasing –COOH groups. No significant differences in surface hydrophobicity was found on surfaces with –CH3 and –CH2CH3 groups in the presence of –COOH groups. The material coating was as smooth as uncoated glass and without any major flaws. The average roughness of material-coated surface (3.99 ± 0.54 nm) was slightly higher than that of uncoated glass surface (2.22 ± 0.29 nm). However, no significant differences in surface average roughness was found among surfaces with the same functionalities at different –COOH ratios nor among surfaces with different alkyl groups but the same –COOH ratios. These suggested that the surface functional groups and their compositions had a combined effect on modulating surface hydrophobicity but not surface roughness. The second part of our study was to investigate the effect of surface functional groups and their compositions on blood cascade activation and structural properties of the formed clots. It was found that surfaces with –COOH/–(CH2)3CH3 induced a faster coagulation activation than those with –COOH/–CH3 and –CH2CH3, regardless of the –COOH ratios. An increase in –COOH ratios on –COOH/–CH3 and –CH2CH3 surfaces decreased the rate of activation. Moreover, all material-coated surfaces markedly reduced the complement activation compared to uncoated glass surfaces, and the pattern of complement activation was entirely similar to that of surface-induced coagulation, suggesting there is an interaction between two cascades. The clots formed on material-coated surfaces had thicker fibrin with a tighter network at the exterior when compared to uncoated glass surfaces. Compared to the clot exteriors, thicker fibrins with a loose network were found in clot interiors. Coated surfaces resulted in more rigid clots with a significantly slower fibrinolysis after 1 h of lysis when compared to uncoated glass surfaces. Significant differences in fibrinolysis after 1 h of lysis among clots on material-coated surfaces correlated well with the differences in fibrin thickness and density at clot exterior. In addition, more growth factors were released during clot formation than during clot lysis. From an intact clot, there was a correlation between the amount of PDGF-AB release and fibrin density. Highest amount of PDGF-AB was released from clots formed on surfaces with 40% –COOH/60% –CH 3 (i.e. 65MMA). During clot lysis, the release of PDGF-AB also correlated with the fibrinolytic rate while the release of TGF-â1 was influenced by the fibrin thickness. This suggested that different clot structures led to different release profiles of growth factors in clot intact and degrading stages. We further validated whether the clots formed on material-coatings provide the microenvironment for improved bone healing by using a rabbit femoral defect model. In this pilot study, the implantation of clots formed on 65MMA coatings significantly increased new bone formation with enhanced chondrogenesis, osteoblasts activity and vascularisation, but decreased inflammatory macrophage number at the defects after 4 weeks when compared to commercial bone grafts ChronOSTM â-TCP granules. Empty defects were observed when blood clot formation was inhibited. In summary, our study demonstrated that surface functional groups and their relative ratios on material coatings synergistically modulate activation of blood cascades, resultant fibrin architecture, rigidity, susceptibility to fibrinolysis as well as growth factor release of the formed clots, which ultimately alter the healing microenvironment of injured bones.

Anti-bacterial surfaces: Natural agents, mechanisms of action, and plasma surface modification

Strategies that confine antibacterial and/or antifouling property to the surface of the implant, by modifying the surface chemistry and morphology or by encapsulating the material in an antibiotic-loaded coating, are most promising as they do not alter bulk integrity of the material. Among them, plasma-assisted modification and catechol chemistry stand out for their ability to modify a wide range of substrates. By controlling processing parameters, plasma environment can be used for surface nano structuring, chemical activation, and deposition of biologically active and passive coatings. Catechol chemistry can be used for material-independent, highly-controlled surface immobilisation of active molecules and fabrication of biodegradable drug-loaded hydrogel coatings. In this article, we comprehensively review the role plasma-assisted processing and catechol chemistry can play in combating bacterial colonisation on medically relevant coatings, and how these strategies can be coupled with the use of natural antimicrobial agents to produce synthetic antibiotic-free antibacterial surfaces.

Reversible and irreversible pH induced conformational changes in self-assembled weak polyelectrolyte multilayers probed using etched fiber Bragg grating sensors

Polyelectrolytes are charged polymer species which electrostatically adsorb onto surfaces in a layer by layer fashion leading to the sequential assembly of multilayer structures. It is known that the morphology of weak polyelectrolyte structures is strongly influenced by environmental variables such as pH. We created a weak polyelectrolyte multilayer structure (similar to 100 nm thick) of cationic polymer poly-allylamine hydrochloride (PAH) and an anionic polymer poly-acrylic acid (PAA) on an etched clad fiber Bragg grating (EFBG) to study the pH induced conformational transitions in the polymer multilayers brought about by the variation in charge density of weak polyelectrolyte groups as a function of pH. The conformational changes of the polyelectrolyte multilayer structure lead to changes in optical density of the adsorbed film which reflects in the shift of the Bragg wavelength from the EFBG. Using the EFBG system we were able to probe reversible and irreversible pH induced transitions in the PAH/PAA weak polyelectrolyte system. (C) 2014 Elsevier B.V. All rights reserved.

Impact dynamics of high Weber number drops on chemically modified metallic surfaces

Hydrophobic/superhydrophobic metallic surfaces prepared via chemical treatment are encountered in many industrial scenarios involving the impingement of spray droplets. The effectiveness of such surfaces is understood through the analysis of droplet impact experiments. In the present study, three target surfaces with aluminum (Al-6061) as base material-acid-etched, Octadecyl Trichloro Silane (OTS) coated, and acid-etched plus OTS-coated-were prepared. Experiments on the impact of inertia dominated water drops on these chemically modified aluminum surfaces were carried out with the objective to highlight the effect of chemical treatment on the target surfaces on key sub-processes occurring in drop impact phenomenon. High speed videos of the entire drop impact dynamics were captured at three Weber number (We) conditions representative of high We (We > 200) regime. During the early stages of drop spreading, the drop impact resulted in ejection of secondary droplets from spreading drop front on the etched surfaces resembling prompt splash on rough surfaces whereas no such splashing was observable on untreated aluminum surface. Prominent development of undulations (fingers) were observed at the rim of drop spreading on the etched surfaces; between the etched surfaces the OTS-coated surface showed a subdued development of fingers than the uncoated surface. The impacted drops showed intense receding on OTS-coated surfaces whereas on the etched surface a highly irregular receding, with drop liquid sticking to the surface, was observed. Quantitative analyses were performed to reveal the effect of target surface characteristics on drop impact parameters such as temporal variation of spread factor of drop lamella, temporal variation of average finger length during spreading phase, maximum drop spreading, time taken to attain maximum spreading, sensitivity of maximum spreading to We, number of fingers at maximum spreading, and average receding velocity of drop lamella. Existing models for maximum drop spreading showed reasonably good agreement with the experimental measurements on the target surfaces except the acid-etched surface. (C) 2014 Elsevier B.V. All rights reserved.

Perturbed frequency-selective surfaces fabricated on large thin polymer membranes for multiband infrared applications

The design, fabrication, and characterization of single-screen perturbed frequency-selective surfaces (FSS) at infrared frequencies for single and multiband applications are reported. Single-band FSS based on parallel strips have been perturbed by decreasing the length of every second strip within the array in order to achieve dual band-stop responses. The same principle has been extended to design FSS exhibiting tri- and quadreflection bands. In addition, strip FSSs have been perturbed by replacing every second strip for a metallic ring, resulting in dual-band filters with different polarization responses of the bands. These designs have been fabricated on large thin polyimide membranes using sacrificial silicon wafers. An oxide interlayer between the sacrificial silicon wafer and the polyimide membrane is employed to stop the silicon etching and is wet etched subsequently by a solution of ammonium fluoride and acetic acid that does not attack either the polyimide membrane or the aluminium FSS elements. Fourier transform infrared spectroscopy measurements are presented to validate the predicted responses of the fabricated prototypes.

Sub-mm wet etched linear to circular polarization fss based polarization converters

This communication investigates the potential for fabrication of micromachined silicon sub-millimeter wave periodic arrays of freestanding slot frequency selective surfaces (FSS) using wet etch KOH technology. The vehicle for this is an FSS for generating circularly polarized signals from an incident linearly polarized signal at normal incidence to the structure. Principal issues and fabrication processes involved from the initial design of the core FSS structures to be made and tested through to their final testing are addressed. Measured and simulated results for crossed and ring slot element shapes in single and double layer polarization convertor structures are presented for sub-mm wave operation. It is shown that 3 dB axial ratio (AR) bandwidths of 21% can be achieved with the one layer perforated screen design and that the rate of change is lower than the double layer structures. An insertion loss of 1.1 dB can be achieved for the split circular ring double layer periodic array. These results are shown to be compatible with the more specialized fabrication equipment dry reactive ion etching approach previously used for the construction of this type of structure. © 2011 IEEE.

Mécanismes de recuit dans le silicium implanté par faisceau d’ion caractérisés par nanocalorimétrie

Nous présenterons le procédé de fabrication, la caractérisation, ainsi qu’un modèle numérique permettant l’optimisation d’un nouveau dispositif permettant d’effectuer des mesures de nanocalorimétrie sur un échantillon de silicium monocristallin. Ce dernier possède entre autre des propriétés thermiques nous permettant d’effectuer des mesures à des températures supérieures à 900 C, avec une résolution meilleure que 16 C. Ceci nous a permis d’étudier la dynamique des défauts induits par implantation ionique dans le silicium monocristallin. Deux comportements différents sont observés dans la germination de la phase amorphe induite par implantation à 10 et 80 keV. Ces résultats ont été confrontés à des simulations Monte-Carlo basées sur le modèle des paires lacunesinterstitiels. La comparaison entre les simulations et les mesures expérimentales ont montré que ce modèle est incomplet car il ne reproduit qualitativement que certaines caractéristiques observées expérimentalement. Des mesures réalisées à partir de -110 C dans le silicium monocristallin et amorphisé implanté avec des ions légers, ont mis en évidence des différences claires entre la relaxation dans le silicium amorphe et le recuit des défauts dans le silicium monocristallin. Deux processus à des énergies d’activation de 0.48 et 0.6 eV ont été observés pour les implantations réalisées dans le silicium monocristallin tandis qu’un relâchement de chaleur uniforme ne révélant qu’un spectre continu d’énergie d’activation a été observé dans le silicium amorphe.

Systematics of properties of the electron gas in deep-etched quantum wires

An efficient method is developed for an iterative solution of the Poisson and Schro¿dinger equations, which allows systematic studies of the properties of the electron gas in linear deep-etched quantum wires. A much simpler two-dimensional (2D) approximation is developed that accurately reproduces the results of the 3D calculations. A 2D Thomas-Fermi approximation is then derived, and shown to give a good account of average properties. Further, we prove that an analytic form due to Shikin et al. is a good approximation to the electron density given by the self-consistent methods.

Influence of implant surface topography on early osseointegration: A histological study in human jaws

The purpose of this study was to evaluate the influence of the oxidized surface on bone-to-implant contact (BIC%), the bone density in the threaded area (BA %), as well as the bone density outside the threaded area (BD%) in human jaws after 2 months of unloaded healing. Thirteen subjects (mean age 42.61 +/- 6.15 years) received two microimplants (2.5 mm diameter and 6 mm length) each, during conventional mandible or maxilla implant surgery. The microimplants with commercially pure titanium surfaces (machined) and oxidized surfaces served as the control and test surfaces, respectively. After 2 months, the microimplants and the surrounding tissue were removed and prepared for histomorphometric analysis. All microimplants, except two machined and one oxidized microimplant surfaces, were found to be clinically stable after the healing period. Histometric evaluation indicated that the mean BIC % was (21.71 +/- 13.11) % and (39.04 +/- 15.75) % for machined and oxidized microimplant surfaces, respectively. The BD% was higher for the oxidized surface, although there was no difference for maxilla and mandible. The oxidized surface impacted the BA% for the type-IV bone. Data suggest that the oxidized surface presented a higher bone-to-implant contact rate compared with machined surfaces under unloaded conditions, after a healing period of 2 months. (c) 2006 Wiley Periodicals, Inc.

Titanium surfaces with nanotopography modulate cytokine production in cultured human gingival fibroblasts

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Argon-based atmospheric pressure plasma enhances early bone response to rough titanium surfaces

This study investigated the effect of an Argon-based atmospheric pressure plasma (APP) surface treatment operated chairside at atmospheric pressure conditions applied immediately prior to dental implant placement in a canine model. Surfaces investigated comprised: rough titanium surface (Ti) and rough titanium surface + Argon-based APP (Ti-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 two 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 Ti, C, and O for the Ti and Ti- Plasma surfaces. Both surfaces presented carbon primarily as hydrocarbon (C?C, C?H) with lower levels of oxidized carbon forms. The Ti-Plasma presented large increase in the Ti (+11%) and O (+16%) elements for the Ti- Plasma group along with a decrease of 23% in surface-adsorbed C content. At 1 week no difference was found in histometric parameters between groups. At 3 weeks significantly higher BIC (>300%) and mean BAFO (>30%) were observed for Ti-Plasma treated surfaces. From a morphologic standpoint, improved interaction between connective tissue was observed at 1 week, likely leading to more uniform and higher bone formation at 3 weeks for the Ti-Plasma treated implants was observed. (C) 2012 Wiley Periodicals, Inc. J Biomed Mater Res Part A 2012.

Biological Performance of Chemical Hydroxyapatite Coating Associated With Implant Surface Modification by Laser Beam: Biomechanical Study in Rabbit Tibias

Purpose: Considering the potential of the association between laser ablation and smaller scale hydroxyapatite (HA) coatings to create a stable and bioactive surface on titanium dental implants, the aim of the present study was to determine, by the removal torque test, the effects of a surface treatment created by laser-ablation (Nd:YAG) and, later, thin deposition of HA particles by a chemical process, compared to implants with only laser-ablation and implants with machined surfaces.Materials and Methods: Forty-eight rabbits received I implant by tibia of the following surfaces: machined surface (MS), laser-modified surface (LMS), and biomimetic hydroxiapatite coated surface (HA). After 4, 8, and 12 weeks of healing, the removal torque was measured by a torque gauge. The surfaces studied were analyzed according to their topography, chemical composition, and roughness.Results: Average removal torque in each period was 23.28, 24.0, and 33.85 Ncm to MS, 33.0, 39.87, and 54.57 Ncm to LMS, and 55.42, 63.71 and 64.0 Ncm to HA. The difference was statistically significant (P < .05) between the LMS-MS and HA-MS surfaces in all periods of evaluation, and between LMS-HA to 4 and 8 weeks of healing. The surface characterization showed a deep, rough, and regular topography provided by the laser conditioning, that was followed by the HA coating.Conclusions: Based on these results, it was possible to conclude that the implants with laser surface modification associated with HA biomimetic coating can shorten the implant healing period by the increase of bone implant interaction during the first 2 months after implant placement. (C) 2009 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 67:1706-1715, 2009