Zirconia implants with improved attachment to the gingival tissue

Abstract

Background Gingival tissue attachment is known to be important for long‐term prognosis of implants. This in vitro study evaluated the gingival attachment to zirconia implants and zirconia implants modified with sol‐gel derived TiO2 coatings. Methods Zirconia endodontic posts (n = 23) were used to function as implants that were inserted into the center of full‐thickness porcine gingival explants (n = 31). The tissue/implant specimens were then individually placed at an air/liquid interface on a stainless‐steel grid in cell culture wells containing a nutrient solution. The tissue cultures were incubated at 37°C in a 5% CO2 environment and at days 7 and 14, the specimens were harvested and analyzed by dynamic mechanical analysis (DMA) measurements under dynamic loading conditions mimicking natural mastication. Specimens were also analyzed by immunohistochemical staining identifying the laminin (Ln) γ2 chain specific for Ln‐332, which is known to be a crucial molecule for the proper attachment of epithelium to tooth/implant surface. Results Tissue attachment to TiO2‐coated zirconia demonstrated higher dynamic modulus of elasticity and higher creep modulus, meaning that the attachment is stronger and more resistant to damage during function over time. Laminin γ2 was identified in the attachment of epithelium to TiO2‐coated zirconia. Conclusions Both DMA and histological analysis support each other, so the gingival tissue is more strongly attached to sol‐gel derived TiO2‐coated zirconia than uncoated zirconia. Immunohistochemical staining showed that TiO2 coating may enhance the synthesis and deposition of Ln‐332 in the epithelial attachment to the implant surface.

Customized Root-Analogue Implants: A Review on Outcomes from Clinical Trials and Case Reports

“…However, this is not straight possible for zirconia and there have been concerns that full zirconia implants might be not so resistant to biofilm formation. This issue was recently demonstrated to be possible to solve with a thin coating of zirconia with TiO 2 -forming formulations [ 35 ], but no such treatment was used in the reported cases. It looks that this matter might need an additional investigation.…”

Biomechanical Properties of Bone and Mucosa for Design and Application of Dental Implants

“…The invariant values [ 24 ] were obtained with BEST method [ 27 ] and can be used for the estimation and prediction of biomaterials and tissue properties without the use of a material model, as was demonstrated in [ 9 , 10 , 20 , 56 , 57 ]. There, the dependence of the material strain ε from the applied stress σ under pseudodifferential time-convolution (accounting for loading history in this case): where α is a material memory value, E 0 is the averaged time-invariant (i.e., not time-dependent) intrinsic modulus, τ 0 is invariant characteristic time, and Γ() is the gamma-function.…”

“…Numerous studies were carried out and clinical data have been collected regarding the shape, design, surface and geometry of abutments and dental screws and their suitability for different tissues’ quality and location [ 1 , 2 , 3 , 9 , 10 , 11 , 12 , 13 ]. Significant differences were also reported for seemingly identical implanted materials but originated from different sources [ 14 ].…”

Oral Tissue Interactions and Cellular Response to Zirconia Implant-Prosthetic Components: A Critical Review

“…As a result, intraosseous implants, components for implants and oral prostheses made from ZrO 2 have attracted the attention of researchers and clinicians due to their biocompatibility properties ( Table 2 ). Materials made from ZrO 2 have consistently shown better biological reactions in periodontal and epithelial tissues where most of the cells are fibroblasts, red-blood cells, platelets, defense and epithelial cells [ 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 ]. In addition, these cells are crucial for the short and long-term success of biomaterials placed in the oral environment although their original task is to protect against contamination from the external environment.…”

“…A comparison in rats [ 99 ] revealed a stronger seal and a more adequate positioning of the formed tissue in order to prevent aggressors in ZrO 2 implants. Furthermore, the expression of laminin-332 suggested regulating the elongation of the peri-implant mucosa, developing an improved biological area [ 99 , 100 ] ( Table 2 ). This combination of results suggests a great potential for zirconia components in sites of epithelial transition, thereby providing more promising biocompatibility factors than the materials conventionally used.…”