Scientifica implantology

Poster IADR General Session, San Francisco, March 22-25, 2017

The in vitro study presented in this poster proposes an alternative technique based on spectrometry to assess debridement of implant surfaces. The tests carried out reveal the excellent wettability of the ZirTi surface of the implants under study.

Acta Biomed 2016; Vol. 87, N. 1: 16-21

This method study, which aimed to investigate two scanning electron microscopy techniques, contextually showed optimal cellular activity on UTM (Ultrathin Threaded Microsurface). At 12000 magnification, the murine cells appeared clear, spread out and with a thicker central nucleus surrounded by cytoplasm.

Journal of Material Science, 2016, 27(68): 1-9, doi: 10.1007/s10856-016-5678-5, early view on line, published online 17 February 2016

This in vitro study reports the results of the activity of the murine osteoblastic cell line MC3T3 on the ZirTi surface and on four different experimental surfaces. The ZirTi surface has demonstrated to be superior to the others in terms of cellular differentiation.

Clinical Oral Implant Research, 2015; [Epub ahead of print]

A histological analysis was made of Premium implants treated with a classic ZirTi surface and with 3 other experimental surfaces. The sites were prepared following the standard protocol or creating a coronal defect. Ground sections at 3 months all showed excellent BIC values, but only the implants with the ZirTi surface had 100% survival.

Clinical Oral Implant Research, 2015; 26:293?299

This in vivo study analysed the histological results of implants with 4 different surfaces inserted bicortically in rabbit tibiae: the conventional ZirTi surface present on Premium implants, and 3 different experimental surfaces. Ground sections were prepared at 5, 8, 15 and 30 days, giving a significant vision of the evolution of the bone healing process in the first month. In particular, a higher percentage increase of the mineralized component of the bone in contact with the implants was demonstrated. The ZirTi surface was once again found to be effective in the osseointegration process.

Clinical Oral Implant Research, 2014; 25 Suppl 10:222

This study reports the preliminary in vitro results of the osteoblastic function of Connexin Cx43 on 4 different surfaces, one with a classic ZirTi morphology and 3 with various experimental patterns. The roughness and morphology of the ZirTi surface was shown to be capable of activating Connexin Cx43, with the consequent release of extracellular stimuli, as with the other experimental surfaces tested.

30th Annual Congress, American Academy of Osseointegration, San Francisco, 12-14 March 2015, Poster Id 2088727

A chemico-morphological characterization was made of Premium implants by means of ESEM-EDX analyses after 28 days of immersion in a simulated body fluid. Surfaces were found to be micro-morphologically uniform on the entire body of the implants, as were the macro-configurations of the screws. At the end of the test, apatite spherulites were detected on all surfaces, demonstrating the capacity of ZirTi surface to nucleate calcium phosphates.

Clinical Oral Implant Research, Early View, First Published online on 2012, December 12th

This in vivo study compared the osteointegration of implants with two different surfaces (standard ZirTi versus experimental ZirTi with dendrimer coating) inserted with two different techniques (sites prepared with conventional drills versus piezoelectric preparation). The dendrimer coating and the use of the piezoelectric technique did not show any statistically significant advantages, in terms of BIC values, with respect to those obtained with conventional preparations and standard ZirTi surfaces.

Clinical Oral Implant Research, Early View, First Published online on 2012, December 5th

This in vitro test demonstrated that the ZirTi surface, with an experimental coating of phosphoserine-tethered poly(epsilon-lysine) dendrons, was able to activate a good osteoblastic differentiation.

Living organisms are characterised by an extraordinary structural complexity consisting of different size levels, from the macroscopic level of the apparatus and systems to the more minute levels of the organisation of the tissues, cells, cell organelle, right through to the nanostructural levels of the interaction between the macromolecules that make up the living organism. However, the characteristics, properties, and capabilities of the organism as a whole depend on these levels, which
are little known and harder to study. Likewise, the objective of replacing missing or damaged portions of the organism with the use of medical devices consisting of biocompatible materials such as intraosseous implants always had to deal with the necessity of integration, even before the macroscopic and functional, microscopic,
cellular and molecular aspects. The cell is the protagonist of this special situation, which is made up of the tissue-biomaterial interface. In fact, it is the cell that colonises the surface of the implant, and it is the cell, guided by mechanical and chemical stimuli coming from the surrounding environment, that must make room for mature and functionally capable tissue in order to reach the clinically desired goal of osseointegration. This complex and delicate process is in reality the result of a concerted action of a series of chemical and physical stimuli that contribute to determining the development of a healthy and functional tissue. The precursors of the bone cells, which reside in the marrow, are positioned inside a series of cells and structures of the extra-cellular matrix that work together to induce the quiescence or cell differentiation: this is the so-called “niche”, a term very dear to biologists who work with stem cells. The stem niche, even before being a histological concept, is a biochemical concept, i.e. the series of spatially organised stimuli that are brought to a precursory cell and that induce its differentiation according to established lineages. Without a correct niche the stem cell cannot differentiate itself or differentiates itself incorrectly. In the last few years, a series of scientific works have strongly
demonstrated that the surface of the implant device is capable of infl uencing the destiny of the cell, of infl uencing its capacity to replicate and its differential potential. Ultimately, this leads to promoting the formation of bone tissue, critical for integration, and fi nally to the success of the implant. Therefore, the ideal implant surface should have the potential and capacity to act as a new niche for the mesenchymal precursors, which go to replace the marrow that is interrupted or disrupted by the introduction of a biomaterial in the bone context and it must be a substitute for the functions. This is an important concept, even if in the past it was sometimes, regretfully or out of ignorance, underestimated. The ace in the hole of the contemporary approach to implant surfaces and materials is understanding the
factors that make up this niche, the knowledge of the stimuli that they can give to the cells, particularly to the cell precursors that are capable of differentiating themselves in mature bone cells: real tissue engineering capable of optimising the bone responses and maximise the integration of the implant in its tissue context. Implantology of the future will be the modulation of the biological signals that control cell differentiation in a harmonic and biomimetic way. This challenge starts from a distance, from painstaking research and analysis of the in-vitro and in-vivo cell responses. It is a long road where each improvement that reaches the dentist conceals a history of attempts, failures, frustrations, but also of enthusiasm, inspirations and discoveries. This road requires the contribution of everyone, including researchers, dentists and users. This journey is diffi cult and challenging, but at the same time, is changing the way of doing dentistry.