Yoritoki Tomotake

Oral factors affecting titanium elution and corrosion: an in vitro study using simulated body fluid.

OBJECTIVES Ti, which is biocompatible and resistant to corrosion, is widely used for dental implants, particularly in patients allergic to other materials. However, numerous studies have reported on Ti allergy and the in vitro corrosion of Ti. This study investigated the conditions that promote the elution of Ti ions from Ti implants. METHODS Specimens of commercially pure Ti, pure nickel, a magnetic alloy, and a gold alloy were tested. Each specimen was immersed in a simulated body fluid (SBF) whose pH value was controlled (2.0, 3.0, 5.0, 7.4, and 9.0) using either hydrochloric or lactic acid. The parameters investigated were the following: duration of immersion, pH of the SBF, contact with a dissimilar metal, and mechanical stimulus. The amounts of Ti ions eluted were measured using a polarized Zeeman atomic absorption spectrophotometer. RESULTS Eluted Ti ions were detected after 24 h (pH of 2.0 and 3.0) and after 48 h (pH of 9.0). However, even after 4 weeks, eluted Ti ions were not detected in SBF solutions with pH values of 5.0 and 7.4. Ti elution was affected by immersion time, pH, acid type, mechanical stimulus, and contact with a dissimilar metal. Elution of Ti ions in a Candida albicans culture medium was observed after 72 h. SIGNIFICANCE Elution of Ti ions in the SBF was influenced by its pH and by crevice corrosion. The results of this study elucidate the conditions that lead to the elution of Ti ions in humans, which results in implant corrosion and Ti allergy.

Survival of immediate implant restoration: A retrospective study through 9-year-observation

PURPOSE The purpose of this retrospective study was to assess the implant survival rate and the risk factors associated with implant failure in patients who had undergone immediate implant restoration. MATERIALS AND METHODS We performed a retrospective review and an outcome assessment of all patients who received immediate implant restoration between 2000 and 2010 in our department at Tokushima University Hospital. The patients were divided into groups on the basis of the predictor variables: age, gender, implant location, and number of implants per jaw. The cumulative implant survival rate in the paired groups was determined by using Kaplan-Meier analysis and the log-rank test. Cox proportional hazards model was subsequently used to identify exposures associated with implant failure. RESULTS Using the Kaplan-Meier method, the survival rates at 1, 3, and 9 years were calculated to be 98.8%, 98.0%, and 94.7%, respectively. No statistically significant association was observed between the implant survival rates and the predictor variables: gender, age, location, and number of implants. CONCLUSIONS Immediate implant restoration is a reliable prosthetic procedure with an acceptable survival rate compared to the conventional implant procedure.

Blue-Violet Laser Modification of Titania Treated Titanium: Antibacterial and Osteo-Inductive Effects

Background Many studies on surface modifications of titanium have been performed in an attempt to accelerate osseointegration. Recently, anatase titanium dioxide has been found to act as a photocatalyst that expresses antibiotic properties and exhibits hydrophilicity after ultraviolet exposure. A blue-violet semiconductor laser (BV-LD) has been developed as near-ultraviolet light. The purpose of this study was to investigate the effects of exposure to this BV-LD on surface modifications of titanium with the goal of enhancing osteoconductive and antibacterial properties. Methods The surfaces of pure commercial titanium were polished with #800 waterproof polishing papers and were treated with anatase titania solution. Specimens were exposed using BV-LD (λ = 405 nm) or an ultraviolet light-emitting diode (UV-LED, λ = 365 nm) at 6 mW/cm2 for 3 h. The surface modification was evaluated physically and biologically using the following parameters or tests: surface roughness, surface temperature during exposure, X-ray diffraction (XRD) analysis, contact angle, methylene blue degradation tests, adherence of Porphyromonas gingivalis, osteoblast and fibroblast proliferation, and histological examination after implantation in rats. Results No significant changes were found in the surface roughness or XRD profiles after exposure. BV-LD exposure did not raise the surface temperature of titanium. The contact angle was significantly decreased, and methylene blue was significantly degraded. The number of attached P. gingivalis organisms was significantly reduced after BV-LD exposure compared to that in the no exposure group. New bone was observed around exposed specimens in the histological evaluation, and both the bone-to-specimen contact ratio and the new bone area increased significantly in exposed groups. Conclusions This study suggested that exposure of titanium to BV-LD can enhance the osteoconductivity of the titanium surface and induce antibacterial properties, similar to the properties observed following exposure to UV-LED.

Influence of Matrix Attachment Installation Load on Movement and Resultant Forces in Implant Overdentures

PURPOSE This in vitro study investigated the effect of attachment installation conditions on the load transfer and denture movements of implant overdentures, and aims to clarify the differences among the three types of attachments, namely ball, Locator, and magnet attachments. MATERIALS AND METHODS Three types of attachments, namely ball, Locator, and magnetic attachments were used. An acrylic resin mandibular edentulous model with two implants placed in the bilateral canine regions and removable overdenture were prepared. The two implants and bilateral molar ridges were connected to three-axis load-cell transducers, and a universal testing machine was used to apply a 50 N vertical force to each site of the occlusal table in the first molar region. The denture movement was measured using a G(2) motion sensor. Three installation conditions, namely, the application of 0, 50, and 100 N loads were used to install each attachment on the denture base. The load transfer and denture movement were then evaluated. RESULTS The resultant force decreased with increasing installation load for all attachments. In particular, the resultant force on implants on the loading side of the Locator attachment significantly decreased when the installation load was increased from 0 to 50 N, and that for magnetic attachment significantly decreased when the installation load was increased from 50 to 100 N. For the residual ridges on the loading side, the direction of the forces for all attachments changed to downward with increasing installation load. Furthermore, the yaw Euler angle increased with increasing installation load for the magnetic attachment. CONCLUSIONS Subject to the limitations of this study, the use of any installation load greater than 0 N is recommended for the installation of ball and Locator attachments on a denture base. Regarding magnetic attachments, our results also recommend installation on a denture base using any installation load greater than 0 N, and suggest that the resultant force acting on the implant can be decreased by increasing the installation load; however, a large installation load of 100 N should be avoided when installing the attachment on the denture base to avoid increasing the denture movement.

Formability and mechanical properties of porous titanium produced by a moldless process

Tailor-made porous titanium implants show great promise in both orthopedic and dental applications. However, traditional powder metallurgical processes require a high-cost mold, making them economically unviable for producing unique devices. In this study, a mixture of titanium powder and an inlay wax binder was developed for moldless forming and sintering. The formability of the mixture, the dimensional changes after sintering, and the physical and mechanical properties of the sintered porous titanium were evaluated. A 90:10 wt % mixture of Ti powder and wax binder was created manually at 70°C. After debindering, the specimen was sintered in Ar at 1100°C without any mold for 1, 5, and 10 h. The shrinkage, porosity, absorption ratio, bending and compressive strength, and elastic modulus were measured. The bending strength (135-356 MPa), compression strength (178-1226 MPa), and elastic modulus (24-54 GPa) increased with sintering time; the shrinkage also increased, whereas the porosity (from 37.1 to 29.7%) and absorption ratio decreased. The high formability of the binder/metal powder mixture presents a clear advantage for fabricating tailor-made bone and hard tissue substitution units. Moreover, the sintered compacts showed high strength and an elastic modulus comparable to that of cortical bone.

A new method to prevent the corrosion of dental metals, during disinfection using functional water: Sacrificial protection

PURPOSE This paper demonstrates a simple method using sacrificial protection for preventing the corrosion of dental metals. METHODS Dental metals are directly connected or/and wound with a pure commercial aluminum/zinc wire/plate with high ionization tendency, before their immersion into oxidizing functional water. CONCLUSION Dental materials such as Co-Cr alloy wires, stainless steel, and Au-Ag-Pd alloys did not corrode when this method was used. Thus, this method is very simple and effective for preventing corrosion of dental metals during disinfection using functional water.

Bone Changes Around Hydroxyapatite and Titanium Implants After Abutment Placement in Rabbits—Observations Using Histological and Three-dimensional Examinations

We have previously developed a computer-aided system for examination of the three-dimensional bone structure around implants and observed the bone changes in the healing period after implant placement. This paper describes the bone changes around hydroxyapatite (HA) and titanium (Ti) implants after abutment placement using histological and three-dimensional examinations. Twenty-four HA and Ti implants were embedded in the tibias of adult male New Zealand white rabbits. After 8 weeks, the abutment had passed through periosteum and was placed under the skin. Rabbits were sacrificed 4 and 8 weeks following abutment placement. In conclusion, histological examination showed that, at 4 weeks after abutment placement, bone resorption around the implant neck was seen in both HA and Ti implants, and at 8 weeks, excessive bone formation was seen around the implant neck. Three-dimensional bone examination showed that abutment placement may affect bone formation and cause additional bone hypertrophy in the bone marrow area.

Antifungal and Mechanical Properties of Tissue Conditioner Containing Plant-Derived Component: An In Vitro Study: Tissue Conditioner with Plant-Derived Component

PURPOSE To evaluate the antifungal activity and mechanical properties of a novel antifungal tissue conditioner containing Juncus powder. MATERIALS AND METHODS Juncus powder was mixed with GC tissue conditioner at concentrations of 2.5%, 5.0%, and 10.0% by mass. The cylindrical specimens of Juncus-mixed tissue conditioner (dimensions: 10 mm in diameter and 2 and 6 mm in height for antimicrobial and mechanical tests, respectively) were prepared. The specimens placed on the bottom of the 24-well tissue culture plate were cultured with Candida albicans CAD1 for 2 and 4 days. The proliferation of the C. albicans in the wells was determined by measuring the optical density of fungal culture, and the surface of the specimens were also observed by scanning electron microscopy (SEM). To assess the mechanical properties of the specimens, the fluidity and hardness of Juncus-mixed tissue conditioner were measured using the methods certified according to ISO 10139-1. RESULTS Juncus-mixed tissue conditioner significantly exhibited growth inhibitory effect in a Juncus concentration-dependent manner after both 2- and 4- day cultures. SEM observation showed that the amount of C. albicans on Juncus-mixed specimens drastically decreased, and biofilm formation was markedly inhibited. Moreover, both mechanical properties were found to be within the ranges regulated and specified by ISO. CONCLUSION These findings demonstrated that the tissue conditioner including Juncus powder has a significant growth inhibitory effect against C. albicans, and it is suggested that the application of Juncus-mixed tissue conditioner may prevent denture stomatitis and oral candidiasis in denture wearers.

Calprotectin and cross-linked N-telopeptides of type I collagen levels in crevicular fluid from implant sites with peri-implant diseases: a pilot study

BackgroundPeri-implant crevicular fluid (PICF) contains calprotectin and NTx, which are markers for inflammation and bone resorption, respectively. The aims of this pilot study were to compare calprotectin and NTx levels in PICF from implant sites with or without peri-implant diseases and to evaluate the usefulness of calprotectin and NTx as diagnostic markers for peri-implant diseases.MethodsThirty-five patients with dental implants participated in this pilot study. PICF samples were collected from peri-implant disease sites (n = 40) and non-diseased (healthy) sites (n = 34) after clinical indicators including probing depth (PD), bleeding on probing (BOP), gingival index (GI), and bone loss (BL) rate were investigated. Calprotectin and NTx amounts in PICF were measured using their respective ELISA kits and then compared between diseased and healthy samples. The relationship between PICF calprotectin or NTx levels and clinical indicator levels was investigated. A receiver operating characteristic (ROC) curve analysis of calprotectin and NTx was performed to predict peri-implant diseases.ResultsCalprotectin and NTx levels in PICF were significantly higher from peri-implant disease sites than from healthy sites. PICF calprotectin amounts correlated with PD, and its levels were significantly higher in the GI-1 and GI-2 groups than in the GI-0 group. PICF NTx amounts correlated with PD and the BL rate. ROC curves indicated that PICF calprotectin and NTx are useful biomarkers for peri-implant diseases.ConclusionsCalprotectin and NTx in PICF have potential as biomarkers for the diagnosis of peri-implant diseases.

Application of porous titanium in prosthesis production using a moldless process: Evaluation of physical and mechanical properties with various particle sizes, shapes, and mixing ratios

The prosthetic applications of titanium have been challenging because titanium does not possess suitable properties for the conventional casting method using the lost wax technique. We have developed a production method for biomedical application of porous titanium using a moldless process. This study aimed to evaluate the physical and mechanical properties of porous titanium using various particle sizes, shapes, and mixing ratio of titanium powder to wax binder for use in prosthesis production. CP Ti powders with different particle sizes, shapes, and mixing ratios were divided into five groups. A 90:10wt% mixture of titanium powder and wax binder was prepared manually at 70°C. After debinding at 380°C, the specimen was sintered in Ar at 1100°C without a mold for 1h. The linear shrinkage ratio of sintered specimens ranged from 2.5% to 14.2%. The linear shrinkage ratio increased with decreasing particle size. While the linear shrinkage ratio of Groups 3, 4, and 5 were approximately 2%, Group 1 showed the highest shrinkage of all. The bending strength ranged from 106 to 428MPa under the influence of porosity. Groups 1 and 2 presented low porosity followed by higher strength. The shear bond strength ranged from 32 to 100MPa. The shear bond strength was also particle-size dependent. The decrease in the porosity increased the linear shrinkage ratio and bending strength. Shrinkage and mechanical strength required for prostheses were dependent on the particle size and shape of titanium powders. These findings suggested that this production method can be applied to the prosthetic framework by selecting the material design.