A Critical Review of Dental Implant Materials with an Emphasis on Titanium versus Zirconia.
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ABSTRACT:
SUBMITTER: Osman RB
PROVIDER: S-EPMC5455450 | biostudies-other | 2015 Mar
REPOSITORIES: biostudies-other
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Project description:Commercially pure titanium (cpTi) remains the material of choice for dental implants due to its surface properties which promote osseointegration. Recently, zirconia (ZrO2) has been used as an alternative material due to its immunity to corrosion, mechanical strength, and biocompatibility. Previous in vitro studies evaluating oral bacterial attachment and mammalian host cell response to cpTi and ZrO2 have yielded mixed results. Thus, the aim of the present study was to systematically evaluate the growth of early-colonizing oral bacteria and mammalian host cells on cpTi and ZrO2 after three clinically-relevant surface treatments: polishing, acid-etching, or sandblasting. Polishing produced smooth surfaces (Sa: 0.08-0.22 μm) while acid-etching (Sa: 0.75-1.20 μm) and sandblasting (Sa: 0.87-1.00 μm) yielded rough variants. All surfaces were relatively hydrophilic (θ c ≤ 31°). Overall, the adherent bacterial count did not significantly differ between cpTi and ZrO2 after 1 or 3 days for all Streptococcus strains (p > 0.05). Bacterial count was only greater on rough versus smooth variants for S. sanguinis and S. salivarius. Acid-etched cpTi induced the highest proliferation of macrophages and fibroblasts but the lowest for pre-osteoblasts after 1 and 3 days. All surfaces exhibited comparable fibroblast and pre-osteoblast proliferation by 7 days. Pre-osteoblast differentiation continually increased between 7 and 14 days and was higher on rougher surfaces. No differences in mammalian cellular attachment on cpTi and ZrO2 were observed. Within the study's limitations, early-colonizing oral bacterial adhesion and mammalian cell growth is similar on both smooth and rough cpTi and ZrO2.
| S-EPMC9072875 | biostudies-literature
Project description:OBJECTIVES:The aim of this study was to perform an in vivo histological comparative evaluation of bone formation around titanium (machined and treated surface) and zirconia implants. For the present study were used 50 commercially pure titanium implants grade IV, being that 25 implants with a machined surface (TiM group), 25 implants with a treated surface (TiT group) and, 25 implants were manufactured in pure zirconia (Zr group). The implants (n = 20 per group) were installed in the tibia of 10 rabbits. The implants distribution was randomized (n = 3 implants per tibia). Five implants of each group were analyzed by scanning electron microscopy and an optical laser profilometer for surface roughness characterization. Six weeks after the implantation, 10 implants for each group were removed in counter-torque for analysis of maximum torque value. The remaining samples were processed, included in historesin and cut to obtain non-decalcified slides for histomorphological analyses and histomorphometric measurement of the percentage of bone-implant contact (BIC%). Comparisons were made between the groups using a 5% level of significance (p < 0.05) to assess statistical differences. The results of removal torque values (mean ± standard deviation) showed for the TiM group 15.9 ± 4.18 N cm, for TiT group 27.9 ± 5.15 N cm and for Zr group 11.5 ± 2.92 N cm, with significant statistical difference between the groups (p < 0.0001). However, the BIC% presented similar values for all groups (35.4 ± 4.54 for TiM group, 37.8 ± 4.84 for TiT group and 34.0 ± 6.82 for Zr group), with no statistical differences (p = 0.2171). Within the limitations of the present study, the findings suggest that the quality of the new bone tissue formed around the titanium implants present a superior density (maturation) in comparison to the zirconia implants.
| S-EPMC6471506 | biostudies-literature
Project description:Zirconia implants have become an alternative to titanium implants due to several advantages. The zirconia implant is relatively esthetic and highly resistant to bacteria. While biomaterial studies for zirconia implants have considerably accumulated, in vivo studies have not yet progressed. In the present study, the functional and biological properties of zirconia implants were analyzed thorough in vitro and in vivo studies. The proliferation properties of periodontal cells on the discs of machined surface titanium, hydroxyapatite coated titanium and zirconia were analyzed, and zirconia was shown to be favorable. In addition, small implant fixtures that can be applied to the jawbone of mice were manufactured and transplanted to C57BL/6 mice. The adhesion molecules expression patterns in peri-implant mucosa suggest a stronger mucosal seal and more adequate prevention of peri-implant epithelium (PIE) elongation in the zirconia implant when compared with other conventional materials. Differential laminin-332 expression in peri-implant mucosa of zirconia implants seems to regulate the PIE elongation. In conclusion, zirconia was found to be promising and advantageous with regards to the mucosal seal. And biological width (BW) of peri-implant mucosa is more desirable in zirconia implants compared to conventional titanium implants.
| S-EPMC6616312 | biostudies-literature
Project description:BackgroundThe success rate of implant-supported prostheses for edentulous patients is relatively high. However, the incidence of biological complications, especially peri-implant mucositis and peri-implantitis, increases yearly after the placement of prostheses. The accumulation of pathogenic bacteria adjacent to a prosthesis is the main cause of biological complications. Titanium, one of the classical materials for implant-supported prostheses, performs well in terms of biocompatibility and ease of maintenance, but is still susceptible to biofilm formation. Zirconia, which has emerged as an appealing substitute, not only has comparable properties, but presents different surface properties that influence the adherence of oral bacteria. However, evidence of a direct effect on oral flora is limited. Therefore, the aim of the present study was to assess the effects of material properties on biofilm formation and composition.MethodsThe proposed study is designed as a 5-year randomized controlled trial. We plan to enroll 44 edentulous (mandible) patients seeking full-arch, fixed, implant-supported prostheses. The participants will be randomly allocated to one of two groups: group 1, in which the participants will receive zirconia frameworks with ceramic veneering, or group 2, in which the participants will receive titanium frameworks with acrylic resin veneering. Ten follow-up examinations will be completed by the end of this 5-year trial. Mucosal conditions around the implants will be recorded every 6 months after restoration. Peri-implant submucosal plaque will be collected at each reexamination, and bacteria flora analysis will be performed with 16S rRNA gene sequencing technology in order to compare differences in microbial diversity between groups. One week before each visit, periodontal maintenance will be arranged. Each participant will receive an X-ray examination every 12 months as a key index to evaluate the marginal bone level around the implants.DiscussionThe current study aims to explore the oral microbiology of patients following dental restoration with zirconia ceramic frameworks or titanium frameworks. The features of the microbiota and the mucosal condition around the two different materials will be evaluated and compared to determine whether zirconia is an appropriate material for fixed implant-supported prostheses for edentulous patients.Trial registrationInternational Clinical Trials Registry Platform (ICTRP) ChiCTR2000029470. Registered on 2 February 2020. http://www.chictr.org.cn/searchproj.aspx?
| S-EPMC7694361 | biostudies-literature
Project description:BackgroundThe aim of this systematic review and meta-analysis was to compare the clinical efficacy of the early dental implant placement protocol with immediate and delayed dental implant placement protocols.MethodsAn electronic and manual search of literature was made to identify clinical studies comparing early implant placement with immediate or delayed placement. Data from the included studies were pooled and quantitative analyses were performed for the implant outcomes reported as the number of failed implants (primary outcome variable) and for changes in peri-implant marginal bone level, peri-implant probing depth, and peri-implant soft tissue level (secondary outcome variables).ResultsTwelve studies met the inclusion criteria. Significant difference in risk of implant failure was found neither between the early and immediate placement protocols (risk difference = -0.018; 95% confidence interval [CI] = -0.06, 0.025; P = 0.416) nor between early and delayed placement protocols (risk difference = -0.008; 95% CI = -0.044, 0.028; P = 0.670). Pooled data of changes in peri-implant marginal bone level demonstrated significantly less marginal bone loss for implants placed using the early placement protocol compared with those placed in fresh extraction sockets (P = 0.001; weighted mean difference = -0.14 mm; 95% CI = -0.22, -0.05). No significant differences were found between the protocols for the other variables.ConclusionsThe available evidence supports the clinical efficacy of the early implant placement protocol. Present findings indicate that the early implant placement protocol results in implant outcomes similar to immediate and delayed placement protocols and a superior stability of peri-implant hard tissue compared with immediate implant placement.
| S-EPMC6500770 | biostudies-literature
Project description:Aside from being known for its excellent mechanical properties and aesthetic effect, zirconia has recently attracted attention as a new dental implant material. Many studies have focused on hydroxyapatite (HA) coating for obtaining improved biocompatibility, however the coating stability was reduced by a byproduct produced during the high-temperature sintering process. In this study, to overcome this problem, we simply coated the zirconia surface with a sol-gel-derived hydroxyapatite (HA) layer and then sintered it at a varied temperature (<1000 °C). The surface showed a nanoporous structure, and there was no crystalline phase other than HA and zirconia when the sintering temperature was 800 °C. The adhesion strength of the HA layer (>40 MPa) was also appropriate as a dental implant application. In addition, in vitro cell experiments using a preosteoblast cell line revealed that the HA-coated zirconia surface acts as a preferable surface for cell attachment and proliferation than bare zirconia surface. In vivo animal experiments also demonstrated that the osteoconductivity of zirconia were dramatically enhanced by HA coating, which was comparable to that of Ti implant. These results suggest that the sol-gel-based HA-coated zirconia has a great potential for use as a dental implant material.
| S-EPMC8245356 | biostudies-literature
Project description:BackgroundLong-term success of implant restoration depends on many factors one of them is the sufficient implant stability which is lowered in compromised bone density sites such as the maxilla as it is categorized as type III & IV bone, so searching for a new innovation and updates in implant material and features is very mandatory. So, the aim of this study was to compare between two implant materials (roxolid and traditional titanium) on the primary and secondary stability of implant retained maxillary overdenture.MethodsEighteen completely edentulous patients were selected. All patients received maxillary implant-retained overdentures and lower complete dentures; patients were divided equally into two groups according to the type of implant materials. Group A received a total number of 36 implants made of roxolid material and Group B received a total number of 36 implants made of traditional titanium alloys. Implant stability was assessed using ostell device, the primary implant stability was measured at the day of implant installation however, secondary implant stability was measured after six weeks of implant placement. Paired t-test was used to compare between primary and secondary stability in the same group and an independent t-test was used to compare between the two groups with a significant level < 0.05.ResultsIndependent t-test revealed a significant difference between the two groups with p -value = 0.0141 regarding primary stability and p-value < 0.001 regarding secondary stability, as roxolid implant group was statistically higher stability than titanium group in both. Paired t- test showed a statistically significant difference in roxolid implant group with p-value = 0.0122 however, there was non-statistically significant difference in titanium group with p-value = 0.636. Mann Whitney test showed a significant difference between the two groups regarding amount of change in stability with p value = 0.191. roxolid implant group showed a higher amount of change in stability than the titanium implant group.ConclusionWithin the limitation of this study, it could be concluded that: Roxolid implants showed promising results regarding primary and secondary stability compared to conventional Titanium implants and can be a better alternative in implant retained maxillary overdentures.Trial registrationRetrospectively NCT06334770 at 26-3-2024.
| S-EPMC11305035 | biostudies-literature
Project description:ObjectivesDental implant abutments are fundamental prosthetic components within dentistry that require optimal biocompatibility. The primary aim of this cross-sectional study was to preliminarily assess differences in the pro-inflammatory cytokine and bone metabolism mediator protein expression in the peri-implant crevicular fluid (PICF) adjacent to transmucosal abutments.Material and methodsAbutments were fabricated from either titanium or zirconia in patients previously receiving single-tooth implant therapy. All subjects sampled in this study had an identical implant system and implant-abutment connection. Participants (n = 46) had an average time of clinical function for 22 months (6.2-72.8 months, ±SD 17 months) and received a clinical and radiographic examination of the implant site at the time of PICF sampling using a paper strip-based sampling technique. Cytokine, chemokine, and bone metabolism mediator quantities (picograms/30 s) were determined using a commercial 22-multiplexed fluorescent bead-based immunoassay instrument. A total of 19 pro-inflammatory cytokines and seven bone metabolism mediators were evaluated.ResultsMultivariable analyses provided no evidence of a group (titanium or zirconia), gender, or age effect with regard to the expression of pro-inflammatory mediators evaluated. Significant (P = 0.022) differences were observed for the bone mediator leptin, with titanium abutments demonstrating significantly elevated levels in comparison with zirconia. Osteopontin demonstrated a significant (P = 0.0044) correlation with age of the subjects.ConclusionsNo significant differences in pro-inflammatory cytokine or bone metabolism mediator profiles were observed biochemically, with the exception of leptin, for the abutment biomaterials of titanium or zirconia The molecular PICF findings support the observed clinical biocompatibility of both titanium and zirconia abutments.
| S-EPMC4096610 | biostudies-literature
Project description:ObjectiveTo assess the efficacy of using a bone substitute material (BSM) in the fixture-socket gap in patients undergoing tooth extraction and immediate implant placement.Materials and methodsMEDLINE, EMBASE, and CENTRAL databases were searched for randomized controlled trials (RCTs). RCTs were screened for eligibility, and data were extracted by two authors independently. Risk of bias (ROB) was assessed using Cochrane's ROB tool 2.0. Primary outcomes were implant failure, overall complications, and soft-tissue esthetics. Secondary outcomes were vertical buccal bone resorption, vertical interproximal bone resorption, horizontal buccal bone resorption, and mid-buccal mucosal recession. Meta-analysis was performed using random-effects model with generic inverse variance weighing. GRADE was used to grade the certainty of the evidence.ResultsAfter screening 19 544 potentially eligible references, 20 RCTs were included in this review, with a total of 848 patients (916 sites). Most included RCTs were deemed of some concerns (53%) or at low (38%) risk of bias, except for overall complications (high ROB). Implant failure did not differ significantly RR = 0.92 (confidence intervals [CI] 0.34 to 2.46) between using a BSM compared with not using a BSM (NoBSM). BSM use resulted in less horizontal buccal bone resorption (MD = -0.52 mm [95% CI -0.74 to -0.30]), a higher esthetic score (MD = 1.49 [95% CI 0.46 to 2.53]), but also more complications (RR = 3.50 [95% CI 1.11 to 11.1] compared with NoBSM. Too few trials compared types of BSMs against each other to allow for pooled analyses. The certainty of the evidence was considered moderate for all outcomes except implant failure (low), overall complications (very low), and vertical interproximal bone resorption (very low).ConclusionBSM use during immediate implant placement reduces horizontal buccal bone resorption and improves the periimplant soft-tissue esthetics. Although BSM use increases the risk of predominantly minor complications.
| S-EPMC8453723 | biostudies-literature
Project description:In vivo implants that are composed of titanium and titanium alloys as raw materials are widely used in the fields of biology and medicine. In the field of dental medicine, titanium is considered to be an ideal dental implant material. Good osseointegration and soft tissue closure are the foundation for the success of dental implants. Therefore, the enhancement of the osseointegration and antibacterial abilities of titanium and its alloys has been the focus of much research. With its many advantages, layer-by-layer (LbL) assembly is a self-assembly technique that is used to develop multilayer films based on complementary interactions between differently charged polyelectrolytes. The LbL approach provides new methods and applications for the surface modification of dental titanium implant. In this review, the application of the LbL technique to surface modification of titanium including promoting osteogenesis and osseointegration, promoting the formation and healing of soft tissues, improving the antibacterial properties of titanium implant, achieving local drug delivery and sustained release is summarized.
| S-EPMC5545601 | biostudies-literature