Maria Hoffman

The effect of hydroxyapatite nanocrystals on early bone formation surrounding dental implants

The knowledge of how nanostructures might affect early bone healing and osseointegration is limited. The aim of this study was to investigate if nanometer thick coatings of hydroxyapatite nanocrystals applied on a moderately rough surface might enhance early bone healing on screw-shaped dental implants and to evaluate if the thickness of the coat influences healing. Sandblasted and acid etched titanium implants coated with two different thicknesses of hydroxyapatite (test implants) and sandblasted and acid etched titanium implants (control implants), were inserted in rabbit tibia. After a healing time of 2, 4 and 9 weeks, a removal torque analysis and a histological evaluation were performed. The results from the removal torque analysis showed a tendency for higher values for the double coated hydroxyapatite after 4 weeks and for both the coated surfaces after 9 weeks of healing. The histological evaluations indicated slightly more new bone formation with the coated implants compared with the control; the differences did not reach statistical significance. The present study could not support the importance of nanometer thick coatings of hydroxyapatite nanocrystals in early bone healing, at least not when applied on a blasted and etched surface and placed in a cortical bone.

Peri-Implant Endosseous Healing Properties of Dual Acid-Etched Mini-Implants with a Nanometer-Sized Deposition of CaP : A Histological and Histomorphometric Human Study

PURPOSE The aim of this histological and histomorphometric study was to compare the early peri-implant endosseous healing properties of a dual acid-etched (DAE) surface (Osseotite, Implant Innovations Inc., Palm Beach Gardens, FL, USA) with a DAE surface modified with nanometer-sized calcium phosphate (CaP) particles (NanoTite, Implant Innovations Inc.) in grafted and mature maxillary bone. MATERIALS AND METHODS Fifteen patients received two mini-implants, 1 with DAE surface (control) and 1 with a DAE + CaP surface (test), to fixate an iliac crest bone graft to the maxilla. A part of each mini-implant was in contact with the grafted bone and a part extended into the native maxillary bone. After a healing period of 3 months, the specimens were harvested and analyzed. RESULTS Overall, a trend was seen for stronger bone response around the test mini-implants in the native bone of the maxilla. However, only the old bone particles measured by percentages of bone-to-implant contact and bone area were statistically significant (p = .025 and p = .042, respectively). CONCLUSIONS The NanoTite surface increases the peri-implant endosseous healing properties in the native bone of the maxilla compared with the Osseotite surface, while this difference was not visible in the bone graft area. This might be a result of the lower remodeling process of the graft.

A novel soft tissue model for biomaterial-associated infection and inflammation - Bacteriological, morphological and molecular observations

Infection constitutes a major risk for implant failure, but the reasons why biomaterial sites are more vulnerable than normal tissue are not fully elucidated. In this study, a soft tissue infection model was developed, allowing the analysis of cellular and molecular responses in each of the sub-compartments of the implant-tissue interface (on the implant surface, in the surrounding exudate and in the tissue). Smooth and nanostructured titanium disks with or without noble metal chemistry (silver, gold, palladium), and sham sites, were inoculated with Staphylococcus epidermidis and analysed with respect to number of viable bacteria, number, viability and gene expression of host cells, and using different morphological techniques after 4 h, 24 h and 72 h. Non-infected rats were controls. Results showed a transient inflammatory response at control sites, whereas bacterial administration resulted in higher recruitment of inflammatory cells (mainly polymorphonuclear), higher, continuous cell death and higher gene expression of tumour necrosis factor-alpha, interleukin-6, interleukin-8, Toll-like receptor 2 and elastase. At all time points, S. epidermidis was predominantly located in the interface zone, extra- and intracellularly, and lower levels were detected on the implants compared with surrounding exudate. This model allows detailed analysis of early events in inflammation and infection associated to biomaterials in vivo leading to insights into host defence mechanisms in biomaterial-associated infections.

Early biocompatibility of poly (ethylene glycol) hydrogel barrier materials for guided bone regeneration. An in vitro study using human gingival fibroblasts (HGF-1)

OBJECTIVES To evaluate the early cellular attachment and viability to modified polyethylene glycol (PEG) hydrogels with the influence of arginine-glycine-aspartic acid (RGD) in an in vitro model system. MATERIAL AND METHODS Human gingival fibroblasts (HGF-1) were cultured on 6 different modalities of PEG hydrogel in hydrophobic polystyrene wells. A total of 7500 cells/well (10,000 cells/cm(2)) were dispersed over the PEG filled wells and incubated in triplicates for 24 h, 7 and 13 days. Cell numbers were calculated by means of a NucleoCounter. Cell viability was determined by measuring lactate dehydrogenase (LDH). For statistical analysis, nonparametric Kruska-Wallis test followed by Dunetts T3 test were used. RESULTS All PEG modifications showed good biocompatibility, as demonstrated by low LDH values per cell at the earlier two time points. After 13 days, all PEG modifications showed significantly lower number of cells compared with the controls, and the MX60 configurations demonstrated significantly higher LDH/cell values compared with the other hydrogels. CONCLUSIONS Modifications of the physio-chemical properties of PEG hydrogels and the addition of RGD and spacers influenced the initial cellular response of cultured HGF-1 cells. With the exception of MX60 after 13 days, all PEG formulations performed similarly well. Early cellular response should be considered when developing PEG-based material for clinical purposes.

In vitro evaluation of barrier function against oral bacteria of dense and expanded polytetrafluoroethylene (PTFE) membranes for guided bone regeneration

AIM This study evaluates biofilm formation and barrier function against Streptococcus oralis of nonresorbable polytetrafluoroethylene (PTFE) guided bone regeneration membranes having expanded (e-PTFE) and dense (d-PTFE) microstructure. MATERIALS AND METHODS Three e-PTFE membranes of varying openness, one d-PTFE membrane, and commercially pure titanium discs were evaluated. All e-PTFE membranes consisted of PTFE nodes interconnected by fibrils. The d-PTFE membrane was fibril-free, with large evenly spaced indentations. The surfaces were challenged with S. oralis and incubated statically for 2-48h. Bacterial colonization, viability, and penetration were evaluated. RESULTS S. oralis numbers increased over time on all surfaces, as observed using scanning electron microscopy, while cell viability decreased, as measured by colony forming unit (CFU) counting. At 24h and 48h, biofilms on d-PTFE were more mature and thicker (tower formations) than on e-PTFE, where fewer layers of cells were distributed mainly horizontally. Biofilms accumulated preferentially within d-PTFE membrane indentations. At 48h, greater biofilm biomass and number of viable S. oralis were found on d-PTFE compared to e-PTFE membranes. All membranes were impermeable to S. oralis cells. CONCLUSIONS All PTFE membranes were effective barriers against bacterial passage in vitro. However, d-PTFE favored S. oralis biofilm formation.

Peri-Implant Endosseous Healing Properties of Dual Acid-Etched Mini-Implants with a Nanometer-Sized Deposition of CaP

PURPOSE The aim of this histological and histomorphometric study was to compare the early peri-implant endosseous healing properties of a dual acid-etched (DAE) surface (Osseotite, Implant Innovations Inc., Palm Beach Gardens, FL, USA) with a DAE surface modified with nanometer-sized calcium phosphate (CaP) particles (NanoTite, Implant Innovations Inc.) in grafted and mature maxillary bone. MATERIALS AND METHODS Fifteen patients received two mini-implants, 1 with DAE surface (control) and 1 with a DAE + CaP surface (test), to fixate an iliac crest bone graft to the maxilla. A part of each mini-implant was in contact with the grafted bone and a part extended into the native maxillary bone. After a healing period of 3 months, the specimens were harvested and analyzed. RESULTS Overall, a trend was seen for stronger bone response around the test mini-implants in the native bone of the maxilla. However, only the old bone particles measured by percentages of bone-to-implant contact and bone area were statistically significant (p = .025 and p = .042, respectively). CONCLUSIONS The NanoTite surface increases the peri-implant endosseous healing properties in the native bone of the maxilla compared with the Osseotite surface, while this difference was not visible in the bone graft area. This might be a result of the lower remodeling process of the graft.

Peri-Implant Endosseous Healing Properties of Dual Acid-Etched Mini-Implants with a Nanometer-Sized Deposition of CaP: A Histological and Histomorphometric Human Study: Peri-Implant Endosseous Healing Properties of Dual Acid-Etched Mini-Implants

PURPOSE The aim of this histological and histomorphometric study was to compare the early peri-implant endosseous healing properties of a dual acid-etched (DAE) surface (Osseotite, Implant Innovations Inc., Palm Beach Gardens, FL, USA) with a DAE surface modified with nanometer-sized calcium phosphate (CaP) particles (NanoTite, Implant Innovations Inc.) in grafted and mature maxillary bone. MATERIALS AND METHODS Fifteen patients received two mini-implants, 1 with DAE surface (control) and 1 with a DAE + CaP surface (test), to fixate an iliac crest bone graft to the maxilla. A part of each mini-implant was in contact with the grafted bone and a part extended into the native maxillary bone. After a healing period of 3 months, the specimens were harvested and analyzed. RESULTS Overall, a trend was seen for stronger bone response around the test mini-implants in the native bone of the maxilla. However, only the old bone particles measured by percentages of bone-to-implant contact and bone area were statistically significant (p = .025 and p = .042, respectively). CONCLUSIONS The NanoTite surface increases the peri-implant endosseous healing properties in the native bone of the maxilla compared with the Osseotite surface, while this difference was not visible in the bone graft area. This might be a result of the lower remodeling process of the graft.