Immunomodulation stimulates the innervation of engineered tooth organ

The sensory innervation of the dental mesenchyme is essential for tooth function and protection. Sensory innervation of the dental pulp is mediated by axons originating from the trigeminal ganglia and is strictly regulated in time. Teeth can develop from cultured re-associations between dissociated dental epithelial and mesenchymal cells from Embryonic Day 14 mouse molars, after implantation under the skin of adult ICR mice. In these conditions however, the innervation of the dental mesenchyme did not occur spontaneously. In order to go further with this question, complementary experimental approaches were designed. Cultured cell re-associations were implanted together with trigeminal ganglia for one or two weeks. Although axonal growth was regularly observed extending from the trigeminal ganglia to all around the forming teeth, the presence of axons in the dental mesenchyme was detected in less than 2.5% of samples after two weeks, demonstrating a specific impairment of their entering the dental mesenchyme. In clinical context, immunosuppressive therapy using cyclosporin A was found to accelerate the innervation of transplanted tissues. Indeed, when cultured cell re-associations and trigeminal ganglia were co-implanted in cyclosporin A-treated ICR mice, nerve fibers were detected in the dental pulp, even reaching odontoblasts after one week. However, cyclosporin A shows multiple effects, including direct ones on nerve growth. To test whether there may be a direct functional relationship between immunomodulation and innervation, cell re-associations and trigeminal ganglia were co-implanted in immunocompromised Nude mice. In these conditions as well, the innervation of the dental mesenchyme was observed already after one week of implantation, but axons reached the odontoblast layer after two weeks only. This study demonstrated that immunodepression per se does stimulate the innervation of the dental mesenchyme

Titanium Nitride and Nitrogen Ion Implanted Coated Dental Materials

Titanium nitride and/or nitrogen ion implanted coated dental materials have been investigated since the mid-1980s and considered in various applications in dentistry such as implants, abutments, orthodontic wires, endodontic files, periodontal/oral hygiene instruments, and casting alloys for fixed restorations. Multiple methodologies have been employed to create the coatings, but detailed structural analysis of the coatings is generally lacking in the dental literature. Depending on application, the purpose of the coating is to provide increased surface hardness, abrasion/wear resistance, esthetics, and corrosion resistance, lower friction, as well as greater beneficial interaction with adjacent biological and material substrates. While many studies have reported on the achievement of these properties, a consensus is not always clear. Additionally, few studies have been conducted to assess the efficacy of the coatings in a clinical setting. Overall, titanium nitride and/or nitrogen ion implanted coated dental materials potentially offer advantages over uncoated counterparts, but more investigation is needed to document the structure of the coatings and their clinical effectiveness

Implant Treatment in the Predoctoral Clinic: A Retrospective Database Study of 1091 Patients

Purpose: This retrospective study was conducted at the Marquette University School of Dentistry to (1) characterize the implant patient population in a predoctoral clinic, (2) describe the implants inserted, and (3) provide information on implant failures. Materials and Methods: The study cohort included 1091 patients who received 1918 dental implants between 2004 and 2012, and had their implants restored by a crown or a fixed dental prosthesis. Data were collected from patient records, entered in a database, and summarized in tables and figures. Contingency tables were prepared and analyzed by a chi-squared test. The cumulative survival probability of implants was described using a Kaplan-Meier survival curve. Univariate and multivariate frailty Cox regression models for clustered observations were computed to identify factors associated with implant failure. Results: Mean patient age (±1 SD) at implantation was 59.7 ± 15.3 years; 53.9% of patients were females, 73.5% were Caucasians. Noble Biocare was the most frequently used implant brand (65.0%). Most implants had a regular-size diameter (59.3%). More implants were inserted in posterior (79.0%) than in anterior jaw regions. Mandibular posterior was the most frequently restored site (43%); 87.8% of implants were restored using single implant crowns. The overall implant-based cumulative survival rate was 96.4%. The patient-based implant survival rate was 94.6%. Implant failure risk was greater among patients than within patients (p \u3c 0.05). Age (\u3e65 years; hazard ratio [HR] = 3.2, p = 0.02), implant staging (two-stage; HR = 4.0, p \u3c 0.001), and implant diameter (wide; HR = 0.4, p = 0.04) were statistically associated with implant failure. Conclusions: Treatment with dental implants in a supervised predoctoral clinic environment resulted in survival rates similar to published results obtained in private practice or research clinics. Older age and implant staging increased failure risk, while the selection of a wide implant diameter was associated with a lower failure risk

Biomaterial Properties of Titanium in Dentistry

Background Among various dental materials and their successful restorative uses, titanium provides an excellent example of integrating science and technology involving multiple disciplines of dentistry including biomaterials, prosthodontics and surgical sciences. Titanium and its alloys have emerged as a material of choice for dental implants fulfilling all requirements biologically, chemically and mechanically. Several excellent reviews have discussed the properties of titanium and its surface characteristics that render it biocompatible. However, in most patients, titanium implants are used alongside several other metals. Presence of different metals in the same oral environment can alter the properties of titanium. Other influencing factors include intra-oral pH, salivary content, and effect of fluorides. Highlight This review discusses the effect of the above-mentioned conditions on the properties of titanium and its alloys. An extensive literature search encompassing the properties of titanium in an altered oral environment and its interaction with other restorative materials is presented. Specific conditions that could cause titanium to corrode, specifically due to interaction with other dental materials used in oral rehabilitation, as well as methods that can be employed for passivation of titanium are discussed. Conclusion This review presents an overview of the properties of titanium that are vital for its use in implant dentistry. From a restorative perspective, interaction between implant restoration metals, intra-oral fluorides and pH may cause titanium to corrode. Therefore, in order to avoid the resulting deleterious effects, an understanding of these interactions is important for long-term prognosis of implant restorations

A review of the methods used to study biocompatibility of Portland cement-derived materials used in dentistry

Advanced restorative dentistry may necessitate the need for surgical intervention to the infected root apex. Once access to the root end is achieved, the root apex is resected and filled with a dental restorative material. The materials currently in use are not satisfactory due to inadequate biocompatibility and failure to achieve desirable properties in an aqueous environment. With the introduction of a new material, essentially Portland cement used in the building industry, these desirable properties have been achieved. This paper reviews the methods of testing biocompatibility of Portland cement used in dentistry.peer-reviewe

A Systematic Review of Recall Regimen and Maintenance Regimen of Patients with Dental Restorations. Part 2: Implant-Borne Restorations

Purpose To evaluate the current scientific evidence on patient recall and maintenance of implant-supported restorations, to standardize patient care regimens and improve maintenance of oral health. An additional purpose was to examine areas of deficiency in the current scientific literature and provide recommendations for future studies. Materials and Methods An electronic search for articles in the English language literature from the past 10 years was performed independently by multiple investigators using a systematic search process. After application of predetermined inclusion and exclusion criteria, the final list of articles was reviewed to meet the objectives of this review. Results The initial electronic search resulted in 2816 titles. The systematic application of inclusion and exclusion criteria resulted in 14 articles that satisfied the study objectives. An additional 6 articles were added through a supplemental search process for a total of 20 studies. Of these, 11 were randomized controlled clinical trials, and 9 were observational studies. The majority of the studies (15 out of 20) were conducted in the past 5 years and most studies were conducted in Europe (15), followed by Asia (2), South America (1), the United States (1), and the Middle East (1). Results from the qualitative data on a combined 1088 patients indicated that outcome improvements in recall and maintenance regimen were related to (1) patient/treatment characteristic (type of prosthesis, type of prosthetic components, and type of restorative materials); (2) specific oral topical agents or oral hygiene aids (electric toothbrush, interdental brush, chlorhexidine, triclosan, water flossers) and (3) professional intervention (oral hygiene maintenance, and maintenance of the prosthesis). Conclusions There is minimal evidence related to recall regimens in patients with implant-borne removable and fixed restorations; however, a considerable body of evidence indicates that patients with implant-borne removable and fixed restorations require lifelong professional recall regimens to provide biological and mechanical maintenance, customized for each patient. Current evidence also demonstrates that the use of specific oral topical agents and oral hygiene aids can improve professional and at-home maintenance of implant-borne restorations. There is evidence to demonstrate differences in mechanical and biological maintenance needs due to differences in prosthetic materials and designs. Deficiencies in existing evidence compel the forethought of creating clinical practice guidelines for recall and maintenance of patients with implant-borne dental restorations

A Current Overview of Materials and Strategies for Potential Use in Maxillofacial Tissue Regeneration

Tissue regeneration is rapidly evolving to treat anomalies in the entire human body. The production of biodegradable, customizable scaffolds to achieve this clinical aim is dependent on the interdisciplinary collaboration among clinicians, bioengineers and materials scientists. While bone grafts and varying reconstructive procedures have been traditionally used for maxillofacial defects, the goal of this review is to provide insight on all materials involved in the progressing utilization of the tissue engineering approach to yield successful treatment outcomes for both hard and soft tissues. In vitro and in vivo studies that have demonstrated the restoration of bone and cartilage tissue with different scaffold material types, stem cells and growth factors show promise in regenerative treatment interventions for maxillofacial defects. The repair of the temporomandibular joint (TMJ) disc and mandibular bone were discussed extensively in the report, supported by evidence of regeneration of the same tissue types in different medical capacities. Furthermore, in addition to the thorough explanation of polymeric, ceramic, and composite scaffolds, this review includes the application of biodegradable metallic scaffolds for regeneration of hard tissue. The purpose of compiling all the relevant information in this review is to lay the foundation for future investigation in materials used in scaffold synthesis in the realm of oral and maxillofacial surgery

Potential biomedical applications of ion beam technology

Electron bombardment ion thrusters used as ion sources have demonstrated a unique capability to vary the surface morphology of surgical implant materials. The microscopically rough surface texture produced by ion beam sputtering of these materials may result in improvements in the biological response and/or performance of implanted devices. Control of surface roughness may result in improved attachment of the implant to soft tissue, hard tissue, bone cement, or components deposited from blood. Potential biomedical applications of ion beam texturing discussed include: vascular prostheses, artificial heart pump diaphragms, pacemaker fixation, percutaneous connectors, orthopedic pros-thesis fixtion, and dental implants

Use of graphene as protection film in biological environments

Corrosion of metal in biomedical devices could cause serious health problems to patients. Currently ceramics coating materials used in metal implants can reduce corrosion to some extent with limitations. Here we proposed graphene as a biocompatible protective film for metal potentially for biomedical application. We confirmed graphene effectively inhibits Cu surface from corrosion in different biological aqueous environments. Results from cell viability tests suggested that graphene greatly eliminates the toxicity of Cu by inhibiting corrosion and reducing the concentration of Cu(2+) ions produced. We demonstrated that additional thiol derivatives assembled on graphene coated Cu surface can prominently enhance durability of sole graphene protection limited by the defects in graphene film. We also demonstrated that graphene coating reduced the immune response to metal in a clinical setting for the first time through the lymphocyte transformation test. Finally, an animal experiment showed the effective protection of graphene to Cu under in vivo condition. Our results open up the potential for using graphene coating to protect metal surface in biomedical application