The effects of the nano-titanium hydrides (nano-γ-TiH) phase on the formation of nanoporous Ti oxide layer by the potential approach (hydrogen fluoride (HF) pretreatment and sodium hydroxide (NaOH) anodization) were investigated using scanning electron microscopy, X-ray photoelectron spectroscopy, X-ray diffractometry, and transmission electron microscopy. The nano-γ-TiH phase was formed by the HF pretreatment with various current densities. After the NaOH anodization, the nano-γ-TiH phase was dissolved and transformed into nanoporous rutile-Ti dioxide (R-TiO2). As the Ti underwent HF pretreatment and NaOH anodization, the microstructure on the surface layer was transformed from α-Ti → (α-Ti + nano-γ-TiH) → (α-Ti + R-TiO2). In-vitro biocompatibility also indicated that the Ti with a hierarchical porous (micro and nanoporous) TiO2 surface possessed great potential to enhance cell adhesion ability. Thus, the potential approach can be utilized to fabricate a promising hierarchical porous surface on the Ti implant for promoting biocompatibility.

This study aimed to evaluate the impact of surface-modified biomedical titanium (Ti) dental implant on osseointegration. The surfaces were modified using an innovative dip-coating technique (IDCT; sandblasted, large-grit, and acid-etched, then followed by coating with the modified pluronic F127 biodegradable polymer). The surface morphology and hemocompatibility evaluations were investigated by field-emission scanning electron microscopy, while the contact analysis was observed by goniometer. The IDCT-modified Ti implant was also implanted in patients with missing teeth by single-stage surgical procedure then observed immediately and again four months after placement by cone-beam computerized tomography (CBCT) imaging. It was found that the IDCT-modified Ti implant was rougher than the dental implant without surface modification. Contact angle analysis showed the IDCT-modified Ti implant was lower than the dental implant without surface modification. The hemocompatibility evaluations showed greater red blood cell aggregation and fibrin filament formation on the IDCT-modified Ti implant. The radiographic and CBCT image displayed new bone formation at four months after the IDCT-modified Ti implant placement. Therefore, this study suggests that the IDCT-modified Ti dental implant has great potential to accelerate osseointegration.

Studies examining the effect of operator experience on the accuracy of static guided implant surgery have used postoperative computed tomography (CT) images to measure the error, with inconsistent results. The purpose of this study was to try to clarify this issue by using a measurement method based on the postoperative optical scan. Thirty dentists were divided into an experienced group and an inexperienced group. On a partially edentulous mandibular model in the manikin head, each dentist placed three implants via the stereolithographic (SLA) surgical guide. The implant positions were identified by a desktop scanner and compared with the planned positions using a metrology software program. No statistically significant differences were observed for any of the measured positional and angular deviations of the three implant sites between experienced and inexperienced operators (p > 0.01). All the mean values of deviations of the inexperienced group, except the depth deviation, were less than the experienced group. Implants inserted by dentists under 40 years old had significantly better accuracy than senior doctors in the global deviation at implant apex (p = 0.006). Within the limits of this study, we concluded that operator experience is not a critical factor in achieving the accuracy of guided implant surgery via the tooth-supported SLA surgical guide. Large deviations could occur even with the aid of the SLA surgical guide, and care must be taken to avoid errors for both experienced and inexperienced operators.

In this study, the innovative dip-coating technique treated titanium (IDCT-Ti) implant with tetrapeptide Gly-Arg-Gly-Asp (GRGD) coating was investigated for its potential to enhance osseointegration. The L929 fibroblast cells were cultured in different concentrations of the GRGD (1%, 2%, and 5%). The cell viability was assessed through 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) assay and live/dead staining. The surface topography and nano-indentation were analyzed by atomic force microscopy. The hemocompatibility was evaluated via field-emission scanning electron microscopy, while contact angle analysis was detected by a goniometer. Radiograph evaluation was determined by panoramic imaging. It was found that the cell growth increased and had a survival rate of more than 70% in 1% GRGD. The mortality of L929 increased with the higher concentration of GRGD. The IDCT-Ti coated with 1% GRGD showed a nano-surface with a Young’s modulus that was similar to human cortical bone, and it displayed greater red blood cell accumulations with abundant fibrin formation. As regards the wettability, the IDCT-Ti coated with 1% GRGD was lower than the SLA (sandblasted, large-grit, and acid-etched) treated implant. The X-ray image exhibited no bone loss around the implant at six months after placement. As a result, this study suggests that the IDCT-Ti implant, coated with 1% GRGD, has a tremendous likeliness to enhance osseointegration.