[Show abstract][Hide abstract] ABSTRACT: This clinical study was aimed at evaluating the accuracy of gingival visual inspection procedures during clinical examination and determining whether differences existed between the maxillary and mandibular gingival biotypes.
The study included 53 patients and 124 clinicians. The clinicians were asked to assign to each subject, using photographic documents, one of three biotypes: thin-scalloped, thick-scalloped, or thick-flat gingival biotype. A total of 19716 responses were collected for statistical analysis.
Identification accuracy of the gingival biotype and the intra-examiner repeatability presented poor highlighting of the limited relevance of visual inspection. In addition, the percent of agreement between classifications based on the global view of both the maxilla and mandible and the classification based on the individual mandibular or maxillary anterior teeth was not statistically significant.
Based on the above results, it can be concluded that a simple visual inspection is not effective for the identification of gingival biotype. Furthermore, evidence suggests that a difference of biotype between the maxilla and the mandible in the same patient is conceivable. Therefore, orthodontic clinical examination should incorporate a reproducible method of determining the individualized gingival biotype for each group of teeth that will be moved.
[Show abstract][Hide abstract] ABSTRACT: Iatrogenic effects of orthodontic forces, in particular root resorption, are described in the literature. However, our knowledge on the risk of osseous defects induced by orthodontic treatment is still scarce. After an overview of histological and biological principles of orthodontically-induced tooth movement, this study focuses on the recent data concerning the occurrence and the treatment of bone resorption associated with orthodontic treatment.
[Show abstract][Hide abstract] ABSTRACT: The surface properties of titanium dental implants are key parameters for rapid and intimate bone-implant contact. The osseointegration of four implant surfaces was studied in the femoral epiphyses of rabbits.
Titanium implants were either grit-blasted with alumina or biphasic calcium phosphate (BCP) ceramic particles, coated with a thin octacalcium phosphate (OCP) layer, or prepared by large-grit sand blasting and acid-etched (SLA). After 2 and 8 weeks of implantation, the bone-implant contact and bone growth inside the chambers were compared. Scanning electron microscopy (SEM) and profilometry showed distinct microtopographies.
The alumina-Ti, BCP-Ti and OCP-Ti groups had similar average surface roughness in the 1-2 mum range whereas the SLA surface was significantly higher with a roughness averaging 4.5 microm. Concerning the osseointegration, the study demonstrated a significantly greater bone-to-implant contact for both the SLA and OCP-Ti surfaces as compared with the grit-blasted surfaces, alumina- and BCP-Ti at both 2 and 8 weeks of healing.
In this animal model, a biomimetic calcium phosphate coating gave similar osseointegration to the SLA surface. This biomimetic coating method may enhance the apposition of bone onto titanium dental implants.
Clinical Oral Implants Research 12/2008; 19(11):1103-10. · 3.43 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The osseointegration of oral implants is related to the early interactions between osteoblastic cells and titanium surfaces. The behaviour of osteoblastic MC3T3-E1 cells was compared on four different titanium surfaces: mirror-polished (Smooth-Ti), alumina grit-blasted (Alumina-Ti) or biphasic calcium phosphate ceramic grit-blasted (BCP-Ti) and a commercially available implant surface (SLA). Scanning electron microscopy and profilometry showed distinct microtopographies. The BCP-Ti group had higher average surface roughness (Ra=2.5 microm) than the other grit-blasted groups. Hydrophilicity and surfaces energies were determined on the different substrates by dynamic contact angle measurements. The most hydrophilic surface was the Alumina-Ti discs, while SLA was the most hydrophobic. The titanium surfaces were all oxidized as TiO2 and polluted by carbon contaminants, as determined by X-ray photoelectron spectroscopy. Alumina-Ti samples also exhibited aluminium peaks as a result of the blasting. The BCP-Ti discs contained traces of calcium and phosphorus. MC3T3-E1 cells attached, spread and proliferated on the substrates. For both the SLA and BCP-Ti groups, the entire surface was covered with a layer of osteoblastic cells after 2 days. At high magnification, the cells exhibited cytoplasmic extensions and filopodia. Compared with plastic, cell viability was similar with the Smooth-Ti, slightly lower with the Alumina-Ti and superior with the SLA and BCP-Ti groups. Alkaline phosphatase activity increased with the culture time whatever the substrate. This study shows that BCP-blasting produces rough titanium implants without surface contaminants.
[Show abstract][Hide abstract] ABSTRACT: Surface modifications at the nanometric scale may promote protein adsorption, cell adhesion and thus favor the osseointegration of metal implants. The behavior of osteoblastic cells was studied on mirror-polished (Smooth-SS) and nanostructured (Nano-SS) stainless steel surfaces.
The nanostructuration was obtained by anodization. The surfaces were characterized by scanning electron, atomic force microscopy (AFM) and X-ray photoelectron specytoscopy. Osteoblastic cells were cultured on these surfaces.
AFM showed a regular array of pores on the Nano-SS. Osteoblastic cells spread more rapidly on Nano-SS surfaces than on Smooth-SS surfaces. Cell viability was similar on Smooth-SS and Nano-SS. Alkaline phosphatase activity increased with culture time whatever the substrate but was better enhanced at 21 days on the Nano-SS than on the Smooth-SS.
This study shows that the nanostructuration of metal implants may improve the adhesion and differentiation of osteoblastic cells.
[Show abstract][Hide abstract] ABSTRACT: Highly bioactive biomaterials have been developed to replace bone grafts in orthopedic revision and maxillofacial surgery for bone augmentation. A mouldable, self-hardening material can be obtained by combining TricOs Biphasic Calcium Phosphate Granules and Tissucol Fibrin Sealant. Two components, calcium chloride and antifibrinolytic agents (aprotinin), are essential for the stability of the fibrin clot. The ingrowth of cells in composites combining sealants without calcium chloride or with a low concentration of aprotinin was evaluated in vivo in an experiment on rabbits. Bone colonization was compared using TricOs alone or with the composite made from TricOs and the standard fibrin sealant. Without the addition of calcium chloride, the calcium ions released by the ceramic component interacted with the components of the sealant too late to stabilize the clot. With a low concentration of aprotinin, the degradation of the clot occurred more quickly, leading to the absence of a scaffold on which the bone cells could colonize the composite. Our results indicate that a stable fibrin scaffold is crucial for bone colonization. The low calcium chloride and low aprotinin groups have shown lower bone growth. Further studies will be necessary to determine the minimal amount of antifibrinolytic agent (aprotinin) necessary to allow the same level of osteogenic activity as the TricOs-fibrin glue composite.
Journal of Materials Science Materials in Medicine 09/2007; 18(8):1489-95. · 2.14 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The osseointegration rate of titanium dental implants is related to their composition and surface roughness. Rough-surfaced implants favor both bone anchoring and biomechanical stability. Osteoconductive calcium phosphate coatings promote bone healing and apposition, leading to the rapid biological fixation of implants. The different methods used for increasing surface roughness or applying osteoconductive coatings to titanium dental implants are reviewed. Surface treatments, such as titanium plasma-spraying, grit-blasting, acid-etching, anodization or calcium phosphate coatings, and their corresponding surface morphologies and properties are described. Most of these surfaces are commercially available and have proven clinical efficacy (>95% over 5 years). The precise role of surface chemistry and topography on the early events in dental implant osseointegration remain poorly understood. In addition, comparative clinical studies with different implant surfaces are rarely performed. The future of dental implantology should aim to develop surfaces with controlled and standardized topography or chemistry. This approach will be the only way to understand the interactions between proteins, cells and tissues, and implant surfaces. The local release of bone stimulating or resorptive drugs in the peri-implant region may also respond to difficult clinical situations with poor bone quality and quantity. These therapeutic strategies should ultimately enhance the osseointegration process of dental implants for their immediate loading and long-term success.
[Show abstract][Hide abstract] ABSTRACT: Calcium phosphate ceramics are currently used as bone graft substitutes in various types of clinical applications. Fibrin glue is also used in surgery due to its haemostatic, chemotactic and mitogenic properties. By combining these two biomaterials, new composite scaffolds were prepared. In this study, we attempt to analyse whether thrombin concentration in the fibrin glue could influence the properties of the composite. The association between fibrin glue and calcium phosphate ceramic granules was characterized at the ultra structural level. Micro and macroporous biphasic calcium phosphate ceramic granules with a diameter of 1-2mm composed of hydroxyapatite and beta-tricalcium phosphate (60/40) were associated to fibrin glue. The composites were observed by scanning and transmission electron microscopy and microcomputed tomography. Fibre thickness, porosity and homogeneity of the fibrin clot were modified by increased the thrombin concentration. Mixing fibrin glue with calcium phosphate granules (1:2) did not modify the microstructure of the fibrin clot in the composite. Nevertheless, thrombin interacted with the bioceramic by inducing the nucleation of crystalline precipitate at the ceramic/fibrin glue interface. Combining fibrin sealant and calcium phosphate ceramics could lead to new scaffolds for bone tissue engineering with the synergy of the properties of the two biomaterials.
[Show abstract][Hide abstract] ABSTRACT: Our purpose was to evaluate the osteointegration of bilayered calcium phosphate (CaP)-coated femoral hip stems in a canine model. A first layer of hydroxyapatite (HA) 20 microm thick and a superficial layer of Biphasic Calcium Phosphate (BCP) 30 microm thick were plasma-sprayed on to the proximal region of sandblasted Ti6Al4V prostheses. Bilayered CaP-coated and non-coated canine femoral stems were implanted bilaterally under general anesthesia in 6 adult female Beagle dogs. After 6 and 12 months, a significant degradation of the bilayered coating occurred with a remainder of 33.1+/-12.4 and 23.6+/-9.2 microm in thickness, respectively. Lamellar bone apposition was observed on bilayered coated implants while fibrous tissue encapsulation was observed on non-coated femoral stems. The bone-implant contacts (BIC) were 91+/-3% and 81+/-8% for coated and 7+/-8% and 8+/-12% for non-coated implants, at 6 and 12 months, respectively. Our study supports the concept of a direct relationship between the biodegradation of CaP coating and the enhanced osteointegration of titanium prostheses. A bilayered CaP coating might therefore enhance bone apposition in the early stages because of the superior bioactivity of the BCP layer while the more stable HA layer might sustain bone bonding over long periods.
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to compare the bone colonization of a macroporous biphasic calcium phosphate (MBCP) ceramic in different sites (femur, tibia, and calvaria) in two animal species (rats and rabbits). A critical size defect model was used in all cases with implantation for 21 days. Bone colonization in the empty and MBCP-filled defects was measured with the use of backscattered electron microscopy (BSEM). In the empty cavities, bone healing remained on the edges, and did not bridge the critical size defects. Bone growth was observed in all the implantation sites in rats (approximately 13.6-36.6% of the total defect area, with ceramic ranging from 46.1 to 51.9%). The bone colonization appeared statistically higher in the femur of rabbits (48.5%) than in the tibia (12.6%) and calvaria (22.9%) sites. This slightly higher degree of bone healing was related to differences in the bone architecture of the implantation sites. Concerning the comparison between animal species, bone colonization appeared greater in rabbits than in rats for the femoral site (48.5% vs. 29.6%). For the other two sites (the tibia and calvaria), there was no statistically significant difference. The increased bone ingrowth observed in rabbit femurs might be due to the large bone surface area in contact with the MBCP ceramics. The femoral epiphysis of rabbits is therefore a favorable model for testing the bone-bonding capacity of materials, but a comparison with other implantation sites is subject to bias. This study shows that well-conducted and fully validated models with the use of small animals are essential in the development of new bone substitutes.
Journal of Biomedical Materials Research Part B Applied Biomaterials 02/2005; 72(1):69-78. · 2.31 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: An ageing population implies an increase in bone and dental diseases, which are in turn a source of numerous handicaps. These pathologies are an expensive burden for the European health system. As no specific bioactive materials are efficient enough to cope with this burden, we have to develop an injectable, mouldable, self-hardening bone substitute to support bone tissue reconstruction and augmentation. New, highly bioactive and suitable biomaterials have been developed to replace bone grafts in orthopedic revision and maxillofacial surgery for bone augmentation. These mouldable, self-hardening materials are based on the association of MBCP Biphasic Calcium Phosphate Granules and Tissucol Fibrin Sealant. The in vivo evaluation of ingrowth in relation to the composite was made in an experiment on rabbits. The results indicate that in the presence of fibrin sealant, newly-formed bone developed at a small distance from the surface of the calcium phosphate ceramic. Two different bone apposition processes were identified. Without the fibrin component (MBCP group), bone rested directly on the surface of the granules. This observation is commonly described as osteoconduction in calcium phosphate materials. On the contrary, the presence of the fibrinogen component seemed to modify this standard osteoconduction phenomenon: the newly-formed bone essentially grew at a distance from the surface of the granules, on the fibrillar network, and could be considered as an inductive phenomenon for osteogenic cell differentiation from mesenchymal stem cells.
Journal of Materials Science Materials in Medicine 02/2005; 16(1):29-35. · 2.14 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This review focuses on bone substitute composites made by mixing ceramic biomaterials with fibrin sealants. Different biomaterials such as coral, bone-derived materials, bioactive glass ceramics, and synthetic calcium phosphate have been mixed with fibrin sealant, resulting in a combination of the biological properties of the two components. This type of association has not produced identical results in all studies. In the past for some, the addition of fibrin sealant to the biomaterial failed to produce any significant, positive effect on osteointegration, whereas others found a positive impact on bone colonization. Despite the negative biological effects reported previously, bioceramic-fibrin composites have been widely used in various types of bone surgery because they are easy to manipulate. In particular, the intra-operative preparation of these composites makes it possible to add bone growth factors or autologous osteoprogenitor cells prior to bone reconstruction. The bone growth factors and autologous osteoprogenitor cells associated with the bioceramic-fibrin composites should provide surgeons with tissue engineered grafts with enhanced osteointegrative properties. This review discusses both the advantages and disadvantages, as well as the future perspectives, of using bioceramic-fibrin composites in various clinical indications.