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Biomedical subjects

Adriano Piattelli

Publications and source records attributed to Adriano Piattelli.

At least 37 records · Page 2Linked to original sources

Screw vs cement-implant-retained restorations: an experimental study in the beagle. Part 2. Immunohistochemical evaluation of the peri-implant tissues.

Crestal bone loss has been reported to occur around dental implants. Even if the causes of this bone loss are not completely understood, the presence of a microgap between implant and abutment with a possible contamination of the internal portion of the implants has been suggested. The aim of this study was to see if there were differences in the vascular endothelial growth factor (VEGF) expression, microvessel density (MVD), proliferative activity (MIB-1), and inflammatory infiltrate in the soft tissues around implants with screwed and cemented abutments. Sandblasted and acid-etched implants were inserted in the mandibles of 6 Beagle dogs. Ten 3.5- x 10-mm root-form implants were inserted in each mandible. A total of 60 implants (30 with screwed abutments and 30 with cemented abutments) were used. After 12 months, all the bridges were removed and all abutments were checked for mobility. A total of 8 loosened screws (27%) were found in the screwed abutments, whereas no loosening was observed in cemented abutments. A gingival biopsy was performed in 8 implants with cemented abutments, in 8 implants with screwed abutments, and in 8 implants with unscrewed abutments. No statistically significant differences were found in the inflammatory infiltrate and in the MIB-1 among the different groups. No statistically significant difference was found in the MVD between screwed and cemented abutments (P = .2111), whereas there was a statistically significant difference in MVD between screwed and unscrewed abutments (P = .0277) and between cemented and unscrewed abutments (P = .0431). A low intensity of VEGF was prevalent in screwed and in cemented abutments, whereas a high intensity of VEGF was prevalent in unscrewed abutments. These facts could be explained by the effects induced, in the abutments that underwent a screw loosening, by the presence of bacteria inside the hollow portion of the implants or by enhanced reparative processes.

Acid Etching, Dental↗

Immediately loaded blade implant retrieved from a after a 20-year loading period: a histologic and histomorphometric case report.

Immediate loading of root-form dental implants has shown promising results and offers treatment cost and convenience advantages to patients. Although blade implants have been immediately loaded for over 2 decades, the ability of this implant design to achieve osseointegration has been debated. The aim of the present study was to histologically evaluate the peri-implant tissues of an immediately loaded blade implant retrieved for abutment fracture after a 20-year loading period. Histologic samples were prepared and examined by light microscope. Compact, cortical, mature bone with well-formed osteons was present at the interface of the implant. Bone-to-implant contact was 51% +/- 6%. The histologic data showed that osseointegration was obtained in an immediately loaded blade implant inserted into the mandible, and that mineralized tissues were maintained at the interface over a long period (20 years).

Blade Implantation↗

Maxillary sinus augmentation using an engineered porous hydroxyapatite: a clinical, histological, and transmission electron microscopy study in man.

Porous hydroxyapatite (HA) is a calcium-phosphate-based material that is biocompatible, nonimmunological, and osteoconductive, and has a macroporosity of about 200 to 800 microm. The pores seem to be able to induce migration, adhesion, and proliferation of osteoblasts inside the pore network and to promote angiogenesis inside the pore system. The aim of this study was to evaluate the clinical behavior and the histological and ultrastructural aspects of porous HA in maxillary sinus augmentation procedures. Twenty-four patients (19 men, 5 women; average age 53.4 years) in good general physical and mental health and with partially or completely edentulous maxillae were selected for this study. Six months after sinus floor elevation, at the time of dental implant placement, biopsies were carried out under local anesthesia. These bone cores were cut in half and were processed for light and transmission electron microscopy. After a mean 3 years after implantation, all implants are clinically in function and no surgical or prosthetic complications have occurred. Under light microscopy, newly formed bone was 38.5% +/- 4.5%, whereas the residual biomaterial represented 12% +/- 2.3% and the marrow spaces represented 44.6% +/- 4.2%. In addition, in the majority of cases, the biomaterial particles were in close contact with the bone, which appeared compact with the characteristic features of well-organized lamellar bone. A cement-like line was slightly visible at the bone-biomaterial interface, but there were no gaps or interposed connective tissue in between. A high quantity (about 40%) of newly formed bone was present. Bone was closely apposed to the biomaterials particles as shown in light microscopy and transmission electron microscopy. Moreover, no signs of inflammatory cell infiltrate or foreign body reaction were present. Also, most of the biomaterial was resorbed and only a small quantity (a little more than 10%) was still present. The results of our study show that porous HA can be a suitable synthetic material for bone regeneration in maxillary sinus augmentation procedures.

Absorbable Implants↗

Bone contact around osseointegrated implants: a histologic study of acid-etched and machined surfaces.

Current literature reports that surface acid etching can improve bone--implant contact (BIC). The aim of this study was to evaluate the differences of BIC between acid-etched (Osseotite) and machined surface implants. Six white New Zealand mature rabbits were used in the present investigation. Each rabbit received two implants, specially made with two surfaces on it (one acid-etched and one machined) into each tibia. A total of 24 implants were inserted. Two animals each were killed at 15, 30, and 60 days after implant placement. Histomorphometry of BIC was statistically evaluated. The acid-etched surfaces showed a greater bone contact percentage than the machined ones during the early phase of healing (15 days), which was not statistically significant. On the other hand, after 30 and 60 days, the differences of BIC between acid-etched and machined surfaces were statistically significant. The acid-etched surface appears to improve BIC at a later stage of healing.

Acids↗

Histological evaluation, in rabbit tibiae, of osseointegration of mini-implants in sites prepared with Er:YAG laser versus sites prepared with traditional burs.

OBJECTIVE: The aim of this study was to evaluate the different bone reactions in rabbit tibiae after the insertion of mini-implants by using two different techniques of site preparation: the superpulsed Er:YAG laser (VPS system) versus the traditional technique with burs. METHODS: One mm wide and 2 mm long implant sites were made in the tibiae of 12 rabbits (8 for each tibia): the authors used an Er:YAG laser with a sapphire tip on a contra-angle hand piece with a 1.0 mm diameter in a VPS mode (with 200 mJ and 30 Hz) to make 4 bone sites and a calibrated traditional bur to drill the other 4 sites in each tibia. The authors inserted a threaded mini-implant, with a sandblasted and acid-etched surface, in the 2 laser implant sites and in the 2 drilled sites of each tibia. The other sites were used as controls. At 0, 7, 15, 30, 45, and 60 days from the surgery, 2 animals each were euthanized, and the retrieved specimens were evaluated. RESULTS: No implant was lost, and the osseointegration was comparable in all implant sites. Histologically, in the 7- and 15-day postoperative specimens, the laser sites showed some amorphous tissue caused by the carbonization of bone during the laser procedure. The sites without implants showed good regeneration of the bone: it was faster in the drill defects because in the laser ones there was some carbonized amorphous tissue. After 30 days postoperatively, the regeneration was the same in all sites. CONCLUSIONS: In comparison with the traditional drilling procedures, Er:YAG laser can be considered efficient in surgery of the bone without inducing irreversible damages, even if it is possible to observe the presence of some carbonized amorphous tissue in the early part of the healing process. This tissue is progressively resorbed in a way similar to a bone graft and doesn't impede the bone formation and osseointegration processes. Further clinical and histological studies are necessary to better define this amorphous tissue and an efficient and safe operative protocol in the surgery of bone with an Er:YAG laser.

Animals↗

Peri-implant bone organization under immediate loading state. Circularly polarized light analyses: a minipig study.

BACKGROUND: Immediate loading of dental implants is currently one of the most examined topics in implant dentistry. Using screw implants with a microstructured surface and bone-quality-adapted insertion procedures, osseointegration is achieved when implants are initially stable and when splinted with the superstructure. Despite reported success, there is a shortage of information relating to remodeling and peri-implant bone formation with immediately loaded implants. METHODS: Four to six immediately loaded and unloaded dental implants with a microstructured surface were placed in the mandible and the maxilla in seven minipigs. A total of 85 implants were placed. After a 4-month healing period, all implants were retrieved. Histomorphometry was performed using a light microscope in transmitted polarized light connected to a high-resolution video camera interfaced to a monitor and personal computer. This optical system was associated with a digitizing pad and a histomorphometry software package with image capturing capabilities. RESULTS: Implants showed osseointegration if the average insertion torque of the implants within one bridge was >35 Ncm. If the primary stability of the bridge was <35 Ncm, all implants in the quadrant were lost after 4 months. The multivariate discriminant analysis showed the highest correlation for implant stability by bridge insertion torque (BIT), localization (mandible or maxilla), and implant insertion torque (IIT) as success parameters. The loaded implants displayed collagen fibers, which were oriented in a more transverse way. In addition, a higher quantity of secondary osteons was present. In comparison, the unloaded implants had collagen fibers with a more parallel orientation, and a higher quantity of marrow spaces was present. CONCLUSIONS: When observed after 4 months, immediately loaded implants showed a higher degree of bone formation and remodeling in comparison to unloaded implants. Immediately loaded implants also demonstrated a prevalence of transversely oriented collagen fibers in the peri-implant bone. In this animal model, an average insertion torque of the implants within one bridge>35 Ncm was associated with the most successful implants.

Animals↗

Histologic evaluation of early human bone response to different implant surfaces.

BACKGROUND: Studies have demonstrated that roughened dental implant surfaces show firmer bone fixation and an increased percentage of bone-to-implant contact (BIC%) compared to commercially pure titanium-surface (machined) implants. Therefore, the purpose of this study was to evaluate the influence of implant-surface topography on human bone tissue after 2 months of unloaded healing. METHODS: Fourteen subjects with a mean age of 46.87 +/- 9.45 years received two microimplants each (2.5 mm in diameter and 6 mm in length), one test (sandblasted acid-etched surface) and one control (machined surface), either in the mandible or in the maxilla. After a healing period of 2 months, the microimplants and surrounding tissues were removed with a trephine bur and prepared for histologic analysis. RESULTS: All microimplants, except for one of the controls, were clinically stable after the healing period. Histometric evaluation indicated that the mean BIC% was 23.08% +/- 11.95% and 42.83% +/- 9.80% for machined and rough microimplant surfaces, respectively (P = 0.0005). The bone area within the threads was also higher for sandblasted-surface implants (P = 0.0005). The mean percentage of bone density did not differ between the two groups (P = 0.578). CONCLUSION: Data from the present histological study suggest that the sandblasted acid-etched implant provides a better human bone tissue response than machined implants under unloaded conditions after a healing period of 2 months.

Acid Etching, Dental↗

Histologic and ultrastructural analysis of regenerated bone in maxillary sinus augmentation using a porcine bone-derived biomaterial.

BACKGROUND: The purpose of the present study was the histologic and ultrastructural evaluation of a biomaterial composed of cortical pig bone in the form of granules. METHODS: After maxillary sinus augmentation using this biomaterial, 10 specimens were retrieved after 5 months in 10 patients using this biomaterial. The specimens were processed to be observed under light microscopy (LM) and transmission electron microscopy (TEM). Histomorphometric measurements were presented by means +/- standard deviations. RESULTS: LM showed that most of the particles were surrounded by newly formed bone. In some areas, the osteoid matrix was present; however, mainly compact bone was present at the interface. There was no evidence of an acute inflammatory infiltrate. The newly formed bone was 36% +/- 2.8% and marrow spaces were 38% +/- 1.6%, whereas residual grafted material was 31% +/- 1.6%. Under TEM, all phases of bone formation (osteoid matrix, woven, and lamellar bone) were observed in proximity with the biomaterial particles. The bone-biomaterial interface showed a close contact between the porcine bone particles and the surrounding bone that had mainly features of mature bone with numerous osteocytes. A lamina limitans was sometimes present at this interface. CONCLUSIONS: According to our knowledge, this is the first study presenting data on TEM of a porcine bone-derived biomaterial used in sinus augmentation procedures in humans. Our findings show that this is a biocompatible biomaterial that can be used for maxillary sinus augmentation procedures without interfering with the normal reparative bone processes.

Absorbable Implants↗

Inflammatory infiltrate, microvessel density, nitric oxide synthase expression, vascular endothelial growth factor expression, and proliferative activity in peri-implant soft tissues around titanium and zirconium oxide healing caps.

BACKGROUND: The aim of the present study in humans was to conduct a comparative immunohistochemical evaluation of vascular endothelial growth factor (VEGF) and nitric oxide synthase (NOS) expression, inflammatory infiltrate, proliferative activity expression, and microvessel density (MVD) in peri-implant soft tissues of titanium and zirconium oxide healing caps. METHODS: Five patients, three men and two women (aged 30 to 66 years; mean: 49 years), participated in this study. All patients received dental implants that were 3.8 mm in diameter and 11 mm in length. All implants were left to heal in a non-submerged (single-stage) mode. Healing caps (3.8 mm in diameter and 3.0 mm in height) were inserted in all implants. Half of the implants were supplied with standard, prefabricated caps of commercially pure titanium, whereas the other half were provided with test zirconium oxide caps. After a 6-month healing period, a gingival biopsy was performed with a circular scalpel (5.5 mm in diameter) around the healing caps of both groups, without unscrewing or removing the healing caps. The dimensions of the gingival biopsies were 1.7 mm (5.5-3.8 mm) in thickness and 3 mm in height. RESULTS: Statistically significant differences were found in the microvessel density between titanium and zirconium oxide healing caps and group II (P < or = 0.0001). Statistically significant differences were likewise found in the low and high intensities of NOS1, NOS3, and VEGF (P < or = 0.0001). In conclusion, the high intensity of NOS1, NOS3, and VEGF were mostly expressed in the titanium group, whereas the low intensity of NOS1, NOS3, and VEGF were mostly expressed in the zirconium oxide group. CONCLUSIONS: In our specimens, the inflammatory infiltrate was mostly present in the titanium specimens. Their extension was much larger than that of the zirconium oxide specimens. Higher values of MVD were observed in the titanium specimens (29.1 versus 15.8). In addition, a higher expression of VEGF intensity was observed in the peri-implant tissues of titanium healing caps, whereas predominantly lower expressions of VEGF intensity were noted around the zirconium oxide healing caps. The Ki-67 expression was higher in the titanium specimens. All these data revealed that the tissues around titanium healing caps underwent a higher rate of inflammation-associated processes, most probably correlated to the higher inflammation processes observed in these tissues. A higher intensity expression of NOS1 and NOS3 was recorded in the tissues around titanium, whereas, on the contrary, a lower intensity of expression was found in the tissues around zirconium oxide specimens. These latter data indicate that the higher expression of these two mediators could be correlated to the higher amount of bacteria present around the titanium samples.

Adult↗

Zirconium implant abutments: fracture strength and influence of cyclic loading on retaining-screw loosening.

OBJECTIVE: The purpose of this study was to determine the fracture strength of zirconium implant abutments and the torque required to unfasten the retaining screw before and after applying cyclic loading to the implant-abutment assembly. The dynamic behavior and stress distribution pattern of zirconium abutments were also evaluated. METHODS AND MATERIALS: Static and cyclic loading of 7 XiVE implants with straight Cercon zirconium abutments were simulated under worst-case conditions. Cyclic loading tests were performed via a servohydraulic dynamic testing machine at loads between 100 and 450 N, for up to 5 million loading cycles, at 15 Hz. The dynamic behavior of the zirconium abutments was analyzed by finite element modeling and Pro/Mechanica software, comparing van-der-Mises and maximum stress levels. RESULTS: Cercon zirconium-ceramic abutments exhibited a maximum fracture strength of 672 N during static loading and 269 N at 800,000 to 5 million cycles runout point, and 403 N at 10,000 cycles runout point during cyclic loading. The mean torque value required to unfasten the abutment retaining screws after (initial) tightening was 21 Ncm +/- 1 and 20 Ncm +/- 1 (measurement accuracy +/- 2 Ncm) after loading with up to 5 million cycles respectively. Torque values decreased minimally and screw loosening did not occur. Within the limited number of test specimens (7), the difference was statistically significant (P = .015). FEM analysis displayed higher stress peaks up to 800 MPa at the cervical aspect of the zirconium abutment and at the apical third of its retaining screw at an external load of 250 N. CONCLUSION: Within the limitations of this study, zirconium implant abutments exceeded the established values for maximum incisal bite forces reported in the literature and tightly fit into the titanium implant after several millions of loading cycles.

Bite Force↗

Genetic effects of anorganic bovine bone (Bio-Oss) on osteoblast-like MG63 cells.

Bio-Oss (Geistlich, Wolhusen, Switzerland) is composed by anorganic bovine bone and is widely used in several bone regeneration procedures in oral surgery. How this biomaterial alters osteoblast gene expression to promote bone formation is poorly understood. We therefore attempted to address this question by using microarray techniques to identify genes that are differentially regulated in osteoblasts exposed to Bio-Oss. By using DNA microarrays containing 20,000 genes, we identified in osteoblast-like cells line (MG-63) cultured with Bio-Oss several genes which expression was significantly up- and down-regulated. The differentially expressed genes cover a broad range of functional activities: (a) signaling transduction, (b) transcription, (c) cell cycle regulation, (d) vesicular transport, (e) apoptosis, and (f) immunity. These results could explain the reported bioaffinity of Bio-Oss to host animals, its biological affinity to osteogenic cells and its capability to stimulate osteoblastic differentiation. The data reported are, to our knowledge, the first genetic portrait of Bio-Oss effects. They can be relevant to our improved understanding of the molecular mechanism underlying bone regenerative procedures and as a model for comparing other materials with similar clinical effects.

Animals↗

Ultrastructure of bone healing in defects grafted with a copolymer of polylactic/polyglycolic acids.

Bone substitutes have been used for the treatment of bone defects. The objective of this study was to ultrastructurally evaluate the healing pattern of bone defects filled with a copolymer of polylactic/polyglycolic acid (FisiograftR) at a time point in which it is expected to be only partially degraded, with the purpose to ultrastructurally analyze how the bone is forming around the grafting material. Three 5-mm-diameter bone defects were created in each tibia from 5 rabbits (average weight 2.5 kg) in which the material was randomly implanted. Animals were sacrificed 30 days after surgery and the 30 bone defects were fixed in 2% glutaraldehyde-2.5% formaldehyde, under microwave irradiation, decalcified in EDTA, embedded in Spurr resin, and examined in a Jeol 1010 TEM. All the bone defects were filled with connective tissue, interspersed with different amounts of the filling material and newly formed bone trabeculae. In areas where the degrading copolymer was present in small amounts, newly formed bone matrix was detected; it was deposited by osteoblast-like cells in close relation to the copolymer. In areas where the degrading copolymer formed accumulates, an amorphous multilayered material was identified between the connective tissue and the copolymer. In summary, the copolymer of PLA/PGA studied appears to be an osteoconductive material when it is used to fill bone defects.

Animals↗

Spindle cell lipoma of the floor of the mouth: report of a case.

Spindle cell lipoma is a benign tumour composed by: (1) mature fat cells; (2) spindle cells; (3) a myxoid matrix separated by thick bands of birefringent collagen. Only 14 cases have been reported in the oral cavity. The authors present the second case located in the floor of the mouth. The treatment of the lesion consists of a local excision.

Humans↗

Effect of Vitamin C on pre-osteoblast gene expression.

Ascorbic acid (AA), also known as Vitamin C, is a cofactor required for the function of several hydroxylases. It is not synthesised in humans and has to be provided by diet. Its absence is responsible for scurvy, a condition related to the defective synthesis of collagen by the reduced function of prolylhydroxylase. AA is also a risk factor for periodontal disease. Recently, it has been shown that AA induces embryonic stem cells to differentiate into osteoblasts. The mechanism by which AA sustains pre-osteoblast proliferation and commitment is mediated through the synthesis of collagen type I, interaction with alpha2- and beta1-integrin, activation of the mitogen-activated protein kinase pathway, and phosphorylation of osteoblast-specific transcription factors. However, the multifunctional role of AA is not fully elucidated. MC3T3-E1 mouse calvaria-derived cell line is a well-defined in vitro model of pre-osteoblast differentiation, and AA is essential for the proliferation and differentiation of MC3T3-E1. By using DNA micro-arrays containing 15,000 genes, we identified several genes in MC3T3-E1 cultured with AA for 24h whose expression was significantly up or downregulated. The differentially expressed genes covered a broad range of functional activities: (1) cell growth; (2) metabolism; (3) morphogenesis; (4) cell death; (5) cell communication. The data reported are, to our knowledge, the first genetic portrait of early stage stimulation of pre-osteoblasts by AA, and may be relevant to better understand the molecular mechanism of pre-osteoblast proliferation and commitment. Elucidation of the molecular mechanism has important clinical implications because it may facilitate the correct use of AA to accelerate bone regeneration.

3T3 Cells↗

Maxillary sinus augmentation with Bio-Oss particles: a light, scanning, and transmission electron microscopy study in man.

Biological interactions occurring at the bone-biomaterial interface are critical for long-term clinical success. Bio-Oss is a deproteinized, sterilized bovine bone that has been extensively used in bone regeneration procedures. The aim of the present study was a comparative light, scanning, and electron microscopy evaluation of the interface between Bio-Oss and bone in specimens retrieved after sinus augmentation procedures. Under light microscopy, most of the particles were surrounded by newly formed bone, while in a few cases, at the interface of some particles it was possible to observe marrow spaces and biological fluids. Under scanning electron microscopy, in most cases, the particle perimeter appeared lined by bone that was tightly adherent to the biomaterial surface. Transmission electron microscopy showed that the bone tissue around the biomaterial showed all the phases of the bone healing process. In some areas, randomly organized collagen fibers were present, while in other areas, newly formed compact bone was present. In the first bone lamella collagen fibers contacting the Bio-Oss surface were oriented at 243.73 +/- 7.12 degrees (mean +/- SD), while in the rest of the lamella they were oriented at 288.05 +/- 4.86 degrees (mean +/- SD) with a statistically significant difference of 44.32 degrees (p < 0.001). In the same areas the intensity of gray value was 172.56 +/- 18.15 (mean +/- SD) near the biomaterial surface and 158.71 +/- 21.95 (mean +/- SD) in the other part of the lamella with an unstatistically significant difference of 13.79 (p = 0.071). At the bone-biomaterial interface there was also an electron-dense layer similar to cement lines. This layer had a variable morphology being, in some areas, a thin line, and in other areas, a thick irregular band. The analyses showed that Bio-Oss particles do not interfere with the normal osseous healing process after sinus lift procedures and promote new bone formation. In conclusion, this study serves as a better understanding of the morphologic characteristics of Bio-Oss and its interaction with the surrounding tissues.

Absorbable Implants↗

Collagen fiber orientation near dental implants in human bone: do their organization reflect differences in loading?

This study is the first to investigate the collagen fiber orientation in human bone around titanium dental implants after loading. Birefringence under circularly polarized light (CPL) and scanning electron microscopy (SEM) investigation were used to assess both collagen orientation and density. Twenty osseointegrated dental implants were retrieved from the mandible bone of 10 patients and were used in the present study. The implants were retrieved after 6 months of function. The birefringence measurements were performed on digitized images using both the peri-implant bone (PB) and the alveolar bone (AB) retrieved at the moment of implant placing. All images detected at 100x were measured using a software image analysis. The results showed that 32.96% (3.208 +/- 0.435 mm(2)) of the PB area was composed of transverse collagen fibers while only 19.70% (1.957 +/- 0.253 mm(2)) was composed of longitudinally collagen fibers. In the AB 26.99% (2.620 +/- 0.520 mm(2)) of the examined area was composed of transverse collagen fibers while 22.25% (2.160 +/- 0.320 mm(2)) was composed of longitudinally collagen fibers. The CPL measurements of the birefringence indicated that the difference in area between the two collagen fibers orientations was statistically significant (p = 0.03) for both AB and PB. In PB the transverse collagen fibers were significantly increased (p < 0.01) than in AB; also the longitudinal collagen fibers differ significantly in the two groups (p = 0.02). The transverse collagen fibers in PB are more present under the lower flank of the threads where the load acts with a compression vectors, while outside the tip of the implant threads the collagen fibers run more longitudinally due to the loads that act with a tensile vectors. SEM observations showed, in the first collagen layers facing the implant surface, a random direction of the collagen fibers, while in the areas away from the implant surface the collagen fibers were well oriented and run parallel. In conclusion, in these loaded dental implants, the bone adjacent to the first two implant threads shows a significant increase of the amount of transverse collagen fibers that were mainly associated with the lower flank of the threads where compressive load acts. The longitudinal collagen fibers also differs significantly from those found in the AB.

Adult↗

Quantitative evaluation of the fibrin clot extension on different implant surfaces: an in vitro study.

The aim of the present study was a quantitative evaluation of the in vitro fibrin clot extension on different implant surfaces. Forty-five disk-shaped commercially pure Grade 2 titanium samples with three different surface topographies (machined, DPS, and Plus) were used in the present study. For the quantitative evaluation of the fibrin clot, 30 specimens were used (10 per group); human whole blood was employed. Venous blood was drawn from three healthy adult volunteers, and 0.2 mL were immediately dropped onto the surface of each specimen. Contact time was 5 min at room temperature; then the samples were rinsed with saline solution and fixed in a buffered solution of glutaraldehyde and paraformaldehyde. Samples were washed again with buffer and dehydrated in an ascending alcohol series. Specimens belonging to all groups were observed under SEM at a magnification of 1000x. From each sample, 50 random micrographs were collected in .tif format with an N x M 1024 x 768 grid of pixels. Quantitative analysis of fibrin clot extension showed the following results: in machined samples fibrin clot extension was 345987.2 +/- 63747.7 pixels(2) (mean +/- SD), in DPS samples fibrin clot extension was 375930.9 +/- 54726.86 pixels(2) (mean +/- SD), and in Plus samples, fibrin clot extension was 612333.6 +/- 46268.42 pixels(2) (mean +/- SD). With ANOVA it was possible to find that there were significant differences among the groups. The Tukey test revealed that the extension of the fibrin clot of Plus samples was statistically higher compared to both machined and DPS samples. The results of this in vitro study indicate that there is a correlation between implant surface morphology and fibrin clot extension. Improvement in surface microtexture complexity seems to determine the formation of a more extensive and three dimensionally complex fibrin scaffold. Further investigations are necessary to explain in more detail the mechanisms that regulate the fibrin clot formation on different implant surfaces.

Adsorption↗

Implant surface roughness influences osteoclast proliferation and differentiation.

The osteoclast is a hematopoietic cell derived from CFU-GM and branches from the monocyte-macrophage lineage during the differentiation process. Biological environment appears to be crucial for osteoclast formation and activity. It has been reported that bone remodeling following implant placement requires a coordinated activity by osteoclasts and osteoblasts. The response of such cells at the bone-implant interface has been suggested to be affected by the structural and morphological features of the biomaterial surface. To shed more light on this topic we performed a multiparametric analysis of murine monocytes response to different titanium surfaces. These cells, RAW 264.7 type TIB-71, represent a very useful system because they differentiate into osteoclasts following treatment of definite doses of the osteoclast-differentiation factor RANKL and macrophage colony-stimulating factor (M-CSF). Cells, cultured on glass (control), on grade 3 machined and on titanium pull-spray superficial-TPSS surfaces disclosed profound different responses in terms of morphological rearrangements, adhesion, and differentiation abilities. Indeed, after 14 days, cells cultured on glass and machined surfaces were uniformly distributed, while, on the TPSS surface cells strictly aggregated into small isolated clusters were observed. In addition, cells cultured on the machined surface displayed a higher adhesion ability, while cells cultured on the rougher surface disclosed a more evident capability to differentiate. These results could explain the higher bone-implant contact percentage found around implants with rougher surfaces and suggest that osteoclasts may play an important role in the initial period after implant placement to prime or prepare the implant surface for the osteoblast activity.

Animals↗