Achieving macro- and micro-roughness on Ti alloy by etching without prior sandblasting: a surface characterization

INTRODUCTION: Etching is currently the most popular method used to texture the surface of dental implants. Sandblasting prior to etching (SLA) is the only method to achieve a macro- and micro-surface texture with a Sa in the 1-2 μm range, a ‘moderately rough’ surface considered to be an optimized surface. However, SLA surfaces harbor remnant particles from the sandblasting process [l]. Some manufacturers consider the residual alumina particles as a foreign material worth getting rid of. Subsequently, they forgo an optimized moderately rough surface and stick to a ‘minimally rough’ micro-roughened surface displaying a Sa < 1 μm [l]. It has been recently claimed [2] that acid etching is typically not an appropriate treatment for α-β alloys because its biphasic nature leads to an enrichment of the Vanadium-rich β-phase on the surface. The aim of the present paper is to show that it is feasible to achieve an optimized ‘moderately rough’ macro- and micro-textured surface on titanium alloy (Ti6Al4V) through etching only, without any prior sandblasting and to characterize the resulting surface

Bactericide effect of powerful Ultrasonic Bone Surgery device (piezo-surgery) : Oral surgey application in BRONJ treatment: (Biphosphonate Related osteonecrosis of the jaws)

I farmaci Bifosfonati sono composti chimici analoghi del pirofosfato e sono in grado di determinare un rallentamento del riassorbimento osseo agendo sul metabolismo degli osteoclasti. L’Osteonecrosi dei mascellari(8-9-10) è stata classificata come una potenziale reazione avversa legata all’uso di farmaci Amino-Bifosfonati ed è da lungo tempo considerata una condizione di difficile risoluzione a causa del rallentato turn-over del metabolismo osseo. L’obiettivo di questo lavoro è stato quello di identificare eventuali presidi chirurgici in grado di risolvere il problema dell’osteonecrosi(11) ed eventualmente impedirne la recidiva, riportata in letteratura come una evenienza frequente. Nel presente studio sono stati trattati 16 pazienti (11 donne e 5 maschi) di età compresa tra 59 e 82 anni,(69aa media). Di questi: 10 pazienti erano stati sottoposti a terapia con bifosfonati a causa di neoplasie metastatizzate, di cui 9 con Acido Zoledronico e 1 con Acido Pamidronico; invece, 6 pz. erano stati trattati per osteoporosi con Acido Alendronico. Undici pazienti riportavano lesioni osteonecrotiche a carico dell’osso mandibolare (10 nella regione anteriore e 1 in quella posteriore); quattro pazienti avevano lesioni a carico del mascellare superiore; un paziente ha avuto una osteonecrosi a carico della mandibola prima ed a distanza di 4 mesi a carico del mascellare superiore; due sul mascellare anteriore, ed altri due sul mascellare posteriore. Per il trattamento chirurgico delle lesioni necrotiche sono state utilizzate attrezzature per la chirurgia ossea ad ultrasuoni ad alta potenza ( 90 Watt) e bassa frequenza (24-32kz) (Ultrasonic-Bone Surgery -U.B.S.). I risultati ottenuti hanno dimostrato che tutti i pazienti trattati avevano avuto una remissione dei sintomi ed una chiusura completa per prima o per seconda intenzione delle ferite entro le prime due settimane dall’intervento. Durante il follow-up (che va da un minimo di 6 mesi fino a 12 mesi) cui sono stati sottoposti tutti i pazienti, non si è manifestata ad oggi alcuna recidiva. Dovrebbero essere presi in considerazione altri pazienti ma gli attuali risultati incoraggiano ulteriori esperimenti in vivo/in vitro in merito all’uso della chirurgia ad ultrasuoni nel trattamento delle osteonecrosi

Treatment of medication-related osteonecrosis of the jaws (MRONJ) with ultrasonic piezoelectric bone surgery. A case series of 20 treated sites

Purpose There is no consensus on how to successfully treat medication-related osteonecrosis of the jaws (MRONJ). We report here on the application of piezoelectric bone surgery to treat MRONJ in combination with antibiotherapy and on its possible benefit.Materiel and methods A cohort of 18 consecutive patients has been treated for MRONJ; they involved 20 sites, 15 in the mandible, and five in the maxilla. Surgical removal of the necrotic areas and debridement was performed with a powerful piezoelectric surgery device (max 90 W) in combination with antibiotherapy. Results All patients healed and obtained a complete soft tissue closure within 1 month. No recurrence of the symptoms was observed during the present follow-up (10–54 months). Conclusion We hypothesize that healing of all treated sites might have resulted from the synergic effect of bone ablation, biofilm alteration, and antibiotic administration. Biofilm alteration might have permitted a better access of antibiotics to the involved germs. These encouraging results warrant further studies on the use of ultrasonic surgery to treat MRONJ patients in order to confirm or refute the hypothesized effect

In vitro modelling of Streptococcus intermedius biofilm on titanium dental implants

Streptococcus intermedius is part of healthy oral flora; it is an opportunist pathogen in endogenous/systemic infections. This strain exhibits a tropism toward different typical biofilm diseases, e.g. periodontititis and peri-implantis. The aim of this study was to determine the biofilm colonization kinetics produced in vitro on titanium dental implants. Biofilm formation was evaluated by a PCR real-time protocol in order to determine the number of S. intermedius cells on the titanium implant surface. The in vitro model showed a striking fast progression of biofilm formation. Coating of salivary proteins on the implant surface peaked after 4 hours. The highest concentration of bacteria on the implant surface was at its highest after 4 hours as well. This indicates that the biofilm reached maturation within 5 hours