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Biomedical subjects

Ann Wennerberg

Publications and source records attributed to Ann Wennerberg.

At least 19 recordsLinked to original sources
PubMed2006

The role of whole blood in thrombin generation in contact with various titanium surfaces.

Understanding of the thrombotic response (activation of the intrinsic coagulation system followed by platelet activation) from blood components upon contact with a titanium dental implant is important and not fully understood. The aims of this study were to evaluate: (1) the thrombogenic response of whole blood, platelet-rich plasma (PRP) and platelet-poor plasma (PPP) in contact with a highly thrombogenic surface as titanium, (2) the thrombogenic response of clinically used surfaces as hydroxyapatite (HA), machined titanium (mTi), TiO2 grit-blasted titanium (TiOB) and fluoride ion-modified grit-blasted titanium (TiOB-F). An in vitro slide chamber model, furnished with heparin, was used in which whole blood, PRP or PPP came in contact with slides of the test surfaces. After incubation (60 min rotation at 22 rpm in a 37 degrees C water bath), blood/plasma was mixed with EDTA or citrate, further centrifuged at +4 degrees C (2200 g at 10 min). Finally, plasma was collected pending analysis. Whole blood in contact with Ti alloy resulted in the binding of platelets to the material surface and in the generation of thrombin-antithrombin (TAT) complexes. With whole blood TAT levels increased 1000-fold compared with PRP and PPP, in which both almost no increase of TAT could be detected. In addition, the platelet activation showed a similar pattern with a 15-fold higher release of beta-TG in whole blood. In the in vitro chamber model with the clinically relevant materials, the fluoride-modified surface (TiOB-F) showed pronounced TAT generation compared with TiOB, mTi and HA. Similar results were achieved for platelet consumption and activation markers of the intrinsic coagulation system. Taken together these results implicate first that whole blood is necessary for sufficient thrombin generation and platelet activation during placement of implants. Second, a fluoride ion modification seems to augment the thrombogenic properties of titanium.

Biocompatible Materials↗
PubMed2006

The role of functional parameters for topographical characterization of bone-anchored implants.

BACKGROUND: The surface topographical characterization of bone-anchored implants has been recommended to be based on amplitude, spatial, and hybrid parameters. There are also functional parameters that have the potential to describe characteristics important for a specific application. PURPOSE: The aim of the present study was to evaluate if parameters that have been described as functional in engineering applications are also relevant in the topographical characterization of bone-anchored implants. MATERIALS AND METHODS: The surface topography of threaded titanium implants with different surface roughness (S(a), S(ds), and S(dr)) was analyzed with an optical interferometer, and five candidating functional parameters (S(bi), S(ci), S(vi), S(m), and S(c)) were calculated. Examples of the same parameters for five commercially available dental implants were also calculated. Results The highest core fluid retention index (S(ci)) was displayed by the turned implants, followed by fixtures blasted with 250- and 25-microm particles, respectively. Fixtures blasted with 75-microm Al(2)O(3) particles displayed the lowest S(ci) value. This is the inverse order of the bone biological ranking based on earlier in vivo studies with the experimental surfaces included in the present study. CONCLUSION: A low core fluid retention index (S(ci)) seems favorable for bone-anchored implants. Therefore, it is suggested to include S(ci) to the set of topographical parameters for bone-anchored implants to possibly predict the biological outcome.

Air Abrasion, Dental↗
PubMed2006

Inflammatory response to a titanium surface with potential bioactive properties: an in vitro study.

BACKGROUND: The current hard tissue implants research aims to accelerate bone healing by designing surfaces that are bioactive. However, the role of the inflammatory response to these surfaces is so far incompletely described. PURPOSE: The aim of the study was to evaluate early inflammatory response in vitro to a potentially bioactive surface--an anodized surface with Mg ions incorporated (anodized/Mg)--and to compare it to a turned, a blasted, and an anodized surface. MATERIALS AND METHODS: An interferometer was used for topographical characterizations. The disks were incubated with human mononuclear cells. Adherent cells were investigated with respect to number of cells, viability, differentiation, and cytokine production with and without lipopolysaccharide stimulation after 24 and 72 hours. RESULTS: The number of adhered mononuclear cells differed significantly between the different modified surfaces, with the highest number on the anodized surface. However, there were no significant differences in cytokine production and differentiation between the different modified surfaces. The amount of anti-inflammatory mediator interleukin-10 remained over time, while the number of cells and pro-inflammatory cytokine tumor necrosis factor-alpha decreased. The cells were viable on all surfaces, respectively. CONCLUSION: The anodized surfaces with and without Mg ions showed an increased cell adherence, however, otherwise an inflammatory response similar to the turned and blasted surfaces. Furthermore, the potentially bioactive anodized/Mg surface showed a similar response to the TiUnite-like anodized surface despite the former having a surface roughness of a smoother character.

Cell Adhesion↗
PubMed2005

The influence of surface topography of ceramic abutments on the attachment and proliferation of human oral fibroblasts.

As different implant abutments are introduced to obtain a sufficient soft tissue barrier, the aim of this study was to determine the effect of three different surface modifications of densely sintered high-purity aluminium oxide on morphology, attachment and proliferation of human gingival fibroblasts. Fibroblasts were cultured on pressed aluminium oxide, milled, and then sintered to full density (1), on pressed, densely sintered (2), and on pressed, densely sintered and then polished surfaces (3). The different surfaces were analyzed using a confocal laser scanner, an atomic force microscope and a scanning electron microscope. The cell profile areas were measured using a semiautomatic interactive image analyzer and the figures were expressed as percent of attachment. The polished specimens had the smoothest surfaces and the roughest were the milled surfaces in terms of height deviation. No difference was found in the spacing between the peaks on the polished surfaces compared to the milled surfaces. Fibroblasts on the milled ceramic appeared to follow the direction of the fine irregularities on the surface. The analyses showed the polished surfaces had significantly higher percentages of initial cell attachment than the other surfaces (P < 0.05). After 3 days of cell culture, significantly more cells were attached to the milled and sintered surfaces than to the polished one, possibly indicating higher proliferation capacity on those types of surfaces.

Aluminum Oxide↗
PubMed2005

In vivo cytokine secretion and NF-kappaB activation around titanium and copper implants.

The early biological response at titanium (Ti), copper (Cu)-coated Ti and sham sites was evaluated in an in vivo rat model. Material surface chemical and topographical properties were characterized using Auger electron spectroscopy, energy dispersive X-ray spectroscopy and interferometry, respectively. The number of leukocytes, cell types and cell viability (release of lactate dehydrogenase) were determined in the implant-interface exudate. The contents of activated nuclear transcription factor NF-kappaB, interleukin-6 (IL-6) and interleukin-10 (IL-10) were determined by enzyme linked immunosorbent assay. An increase in the number of leukocytes, in particular, polymorphonuclear leukocytes, was observed between 12 and 48 h around Cu. A marked decrease of exudate cell viability was found around Cu after 48 h. The total amounts of activated NF-kappaB after 12 h was highest in Ti exudates whereas after 48 h the highest amount of NF-kappaB was detected around Cu. The levels of cytokine IL-6 were consistently high around Cu at both time periods. No differences in IL-10 contents were detected, irrespective of material/sham and time. The results show that materials with different toxicity grades (titanium with low and copper with high toxicity) exhibit early differences in the activation of NF-kappaB, extracellular expression and secretion of mediators, causing major differences in inflammatory cell accumulation and death in vivo.

Animals↗
PubMed2005

Bone formation at titanium implants prepared with iso- and anisotropic surfaces of similar roughness: an in vivo study.

BACKGROUND: Implant surface topography influences the bone response after implantation. However, the importance of surface orientation is not known. PURPOSE: The aim of this study was to investigate the bone tissue response and the stability of titanium implants prepared with isotropic and anisotropic surfaces of similar roughness. MATERIALS AND METHODS: A total of 18 implants were divided into two groups and were inserted into the femurs of nine rabbits for 12 weeks. Confocal laser scanning microscopy was used for the topographic description to verify that the two different surfaces were modified as intended. The stability of the implants was recorded by resonance frequency (RF) measurements at insertion and at time of removal, after which the implants were evaluated histomorphometrically. RESULTS: RF measurements showed that implant stability increased with time. However, there was no significant difference between the two different surface modifications at insertion and after 12 weeks. The histomorphometric comparison revealed no statistically significant differences in regard to either bone-to-metal contact or bone area inside the threads. CONCLUSION: Titanium implants prepared with isotropic and anisotropic surfaces of similar roughness integrate similarly to bone during the 3 months after implantation.

Animals↗
PubMed2005

An antibacterial surface on dental implants, based on the photocatalytic bactericidal effect.

BACKGROUND: It is well known that the moderately roughened surfaces of dental implants enhance direct bone-implant contact. However, rough implant surfaces, as compared to smooth surfaces, are thought to pose a higher risk of bacterial infection when exposed to the oral cavity. PURPOSE: This study was focused on evaluating the photocatalytic bactericidal effects of anatase titanium dioxide (TiO(2)) on gram-negative anaerobic bacteria known to be associated with periimplantitis. MATERIALS AND METHODS: A film of photocatalytic anatase TiO(2) was added onto the surface of commercially pure titanium disks by plasma source ion implantation (PSII) followed by annealing. The photocatalytic properties of the film were confirmed by the degradation of methylene blue. Actinobacillus actinomycetemcomitans and Fusobacterium nucleatum cells were incubated anaerobically and seeded on the disk. The disks were then exposed to ultraviolet A (UVA) illumination from black light in an anaerobic environment. After illumination, the number of viable cells was counted in terms of colony-forming units. RESULTS: The anatase TiO(2) film added by the PSII method and annealing exhibited a strong photocatalytic reaction under UVA illumination. The viability of both types of bacteria on the photocatalytic TiO(2) film was suppressed to less than 1% under UVA illumination within 120 minutes. CONCLUSION: The bactericidal effect of the TiO(2) photocatalyst is of great use for sterilizing the contaminated surface of dental implants.

Aggregatibacter actinomycetemcomitans↗
PubMed2005

Implant stability during initiation and resolution of experimental periimplantitis: an experimental study in the dog.

BACKGROUND: Histologic studies have demonstrated the possibility to reestablish direct bone-implant contacts after ligature-induced periimplantitis. The influence of the reosseointegration on the stability of implants is not known. PURPOSE: The aim of the present investigation was to study bone tissue and associated implant stability alterations that occurred during induction and resolution of periimplantitis using resonance frequency analysis (RFA), radiography, and histology. MATERIALS AND METHODS: Three implants with smooth (turned) or roughened (SLA) surfaces were placed in each side of the edentulous mandible of four dogs. Experimental periimplantitis was induced for 3 months. Five weeks later, the animals were treated with antibiotics and surgical therapy and were followed for another 6 months. Periapical radiographs and RFA were used to evaluate marginal bone levels and implant stability throughout the study period. After termination, the tissue-implant interface was evaluated by light microscopy in ground sections. RESULTS: There was a linear relationship between radiographic and RFA findings because continuous loss of marginal bone and a decrease in implant stability were observed for both implant surfaces during the periimplantitis period. Antibiotic treatment and surgical therapy resulted in some reosseointegration, which was more marked for the SLA surface. The resonance frequency values corresponded well to the histometric measurements because reosseointegration resulted in an increase in implant stability. CONCLUSIONS: The findings from the present study indicate a linear relationship between marginal bone level and resonance frequency value. It is suggested that the RFA technique is sensitive and may be used to detect even a minor change in the level of bone-implant contact.

Alveolar Bone Loss↗
PubMed2005

Screw preloads and measurements of surface roughness in screw joints: an in vitro study on implant frameworks.

BACKGROUND: With the development of milled titanium implant frameworks, new surfaces that have not previously been studied are now being used in screw joints. PURPOSE: The aims of the present study were to compare the preload produced in screw-retained titanium and gold alloy frameworks and the preload for titanium frameworks before and after the application of veneers. Another aim was to try to relate the surface roughness of the screw joints to variations in preload. MATERIALS AND METHODS: Ten identical titanium and five gold alloy frameworks were fabricated. The gold screws were tightened to 10 Ncm. Preload measurements were made for the gold alloy frameworks and before and after the porcelain or acrylic resin veneers had been applied to the titanium frameworks. Surface roughness measurements were made after preload measurements on the screw joint surfaces of the titanium frameworks and corresponding gold screws. RESULTS: The preloads for the titanium and gold alloy frameworks were similar. Preload in both types of frameworks decreased after repeated torques (p<.05-.01) but was unaffected by the application of veneering materials to the titanium frameworks (p>.05). No relationship (p>.05) between preload and surface roughness characteristics was observed. Loaded titanium framework screw sites, however, had lower mean S(a) values than unloaded sites (p<.001), whereas the surfaces of loaded gold screws had higher mean S(a) values compared with the surfaces of control gold screws (p<.05-.001). CONCLUSION: When using gold screws, milled titanium frameworks have preloads similar to those of gold alloy frameworks and preloads for both decrease after repeated tightening. The preload was similar before and after the veneering of the titanium frameworks. Unloaded milled titanium screw sites had rougher surfaces than loaded, and loaded gold screws had rougher surfaces than unloaded. However, no correlation between screw joint surface and preload was observed for veneered titanium frameworks.

Computer-Aided Design↗
PubMed2005

The impact of oral implants - past and future, 1966-2042.

This paper traces the history of oral implants, beginning with their early undocumented use in the mid-1960s. Although early experimentation with the Brånemark system of osseointegration was unsuccessful, significant improvements and scrupulous documentation of the 1970s led to their general acceptance. George Zarb spearheaded their introduction into North America and application of the osseointegration technique soon expanded to extraoral craniofacial prostheses and bone-anchored hearing aids.New possibilities, such as altered surface properties and the use of implants in grafted and irradiated bone are currently being explored, although commercial pressure to introduce new products before they are adequately tested is a cause for concern. The future will see bioactive surfaces and additives that stimulate bone growth. In fact, with the possibility of in vivo growth of new teeth, implants may become unnecessary.

Canada↗
PubMed2004

Variation in surface texture measurements.

Surface texture influences cellular response to implants, implant wear, and fixation, yet measurement and reporting of surface texture can be confusing and ambiguous. Seven specimens of widely different surface textures were submitted to three internationally renowned laboratories for surface texture characterization. The specimens were from dental implants, orthopedic implants, and femoral heads. Areas to be measured were clearly marked; simplified instructions were supplied but specific measurement parameters were not requested. Techniques used included contact profilometry, two- and three-dimensional laser profilometry, and atomic force microscopy. Four to thirteen parameters were reported, 2D or 3D, including R(a) or S(a); only three were common to all centers. The results varied by as much as +/-300-1000%, depending on technique and surface type. Some surfaces were not measurable by some techniques. One dental implant surface was reported with R(a) of 0.17, 0.85, 1.9, and 4.4 microm. The CoCr femoral head ranged from an R(a) of 0.011 to 0.10 microm; the zirconia head from 0.006 to 0.05 microm. Similar variability was reported for the other parameters. Useful surface texture characterization requires reporting of all measurement parameters. Comparisons between studies may be compromised if differences in technique are not considered.

Dental Implants↗
PubMed2004

Influence of chemo-mechanical caries removal on the surface topography of dental composite resin and glass-ionomer materials: an in vitro study.

The aim of the present study was to investigate the influence of a chemo-mechanical caries removal system, Carisolv gel, on the surface topography of dental filling materials. Thirty specimens of a composite resin (Spectrum) and a compomer (Dyract AP) and 60 specimens of a glass-ionomer (Ketac-Fil Plus) were prepared. The surface topography was investigated with an optical interferometer before and after chemical exposure for 5, 10, or 20 min. Each specimen acted as its own control. The topographical part of the glass-ionomer materials was performed in two series with different drying procedures, since this material exhibits a higher sensitivity to dehydration than the other materials. The surface topographical investigations were complemented with contact angle measurements. After Carisolv gel exposure the density of summits and the developed surface area ratio (3D/2D) were slightly smaller for the composite resin and the compomer. For the minimally dried glass-ionomer material, the results indicated a reduction of the height of the surface structures, as well as a surface area enlargement, after Carisolv gel exposure. No statistically significant changes of contact angles due to Carisolv gel exposure could be detected for any material investigated. If dental filling materials of composite resin or glass-ionomer materials are exposed to Carisolv gel, no or only minor surface topographical changes can be expected. n

Compomers↗
PubMed2004

Titanium release from implants prepared with different surface roughness.

OBJECTIVES: There may be a risk of greater ion release for surface-enlarged implants than conventionally turned components. The major aim of the present paper was to investigate whether a correlation exists between ion release and a surface roughness relevant for today's commercial implants. Other aims were to compare ion release after two insertion times and concentration in bone tissue as a function of distance from the implant surface. MATERIAL AND METHODS: Lactic acid aqueous solution (pH=2.3) and phosphate-buffered saline were used for the in vitro investigation. For the in vivo investigation, synchrotron radiation X-ray fluorescence (SRXRF) spectroscopy and secondary ion mass spectroscopy (SIMS) were performed 12 weeks and 1 year after implantation in rabbit tibiae. RESULTS: The average height deviation (S(a)) was 0.7, 1.27, 1.43 and 2.21 microm, respectively, for the four surfaces investigated. No difference in ion release was found in vitro. In vivo, SRXRF demonstrated slightly higher values for the roughest surface up to a distance of 400 microm from the implant surface; thereafter no difference was found. SIMS demonstrated no difference in ion release for the roughest and smoothest surfaces, but slightly more titanium in bone tissue after 1 year than after 12 weeks. Titanium rapidly decreased with distance from the implant surface. CONCLUSION: At a level relevant for commercial oral implants, no correlation was found between increasing roughness and ion release, neither in vitro nor in vivo.

Air Abrasion, Dental↗
PubMed2003

An in vivo study of bone response to implants topographically modified by laser micromachining.

Dental implants topographically modified by laser ablation of periodic arrays of micron-sized craters, were studied in a two-part laboratory investigation. The patterned and control (turned) implants were inserted in rabbit femur and tibia. After 12 weeks the fixation in the bone was evaluated mechanically or by histomorphometry (all threads along the implant and the three best consecutive threads were analysed). In the pilot study no difference was found with respect to bone-to-implant contact and peak removal torque. Significantly more bone was found for the control implants when measuring the bone area inside the threads in the tibia. In the second part of the study, the pattern was improved and significantly more bone-to-implant contact was found for the laser-machined implants. The second part of the study also demonstrated significantly greater peak removal torque values in the tibia with the test implants than the control implants.

Animals↗
PubMed2003

Some soft tissue characteristics at implant abutments with different surface topography. A study in humans.

BACKGROUND: : If an implant with a rough surface is exposed to the oral cavity, it may accumulate greater amounts of plaque than a smooth surface, which may lead to severe problems with mucositis and peri-implantitis. The purpose of the present paper was to investigate the early inflammatory response to mucosa-penetrating abutments prepared with varying surface roughness. METHODS: : Nine patients had all five of their original abutments exchanged to test abutments for a 4-week period. The test abutments were prepared with five different roughnesses. The surface roughness was measured with an optical profilometer. At the end of the test period, clinical evaluation was performed; the health of the surrounding mucosa, the amount of accumulated plaque and marginal bleeding were registered. One biopsy was taken from each test abutment. Qualitative and quantitative histological evaluations were performed. RESULTS: : There was a statistically significant difference between patients regarding the amount of accumulated plaque on the abutment surfaces and inflammatory cells, but no difference between the surface modifications in relation to plaque accumulation or number of inflammatory cells. CONCLUSION: : No relation was found between inflammatory response and abutment surface roughness after an evaluation time of 4 weeks in a human test model.

Aluminum Oxide↗
PubMed2003

Quality of dental implants.

BACKGROUND: Clinicians need quality research data to decide which dental implant should be selected for patient treatment. AIM(S)/OBJECTIVE(S): To present the scientific evidence for claims of relationship between characteristics of dental implants and clinical performance. STUDY DESIGN: Systematic search of promotional material and Internet sites to find claims of implant superiority related to specific characteristics of the implant, and of the dental research literature to find scientific support for the claims. MAIN OUTCOME MEASURES: Critical appraisal of the research documentation to establish the scientific external and internal validity as a basis for the likelihood of reported treatment outcomes as a function of implant characteristics. RESULTS: More than 220 implant brands have been identified, produced by about 80 manufacturers. The implants are made from different materials, undergo different surface treatments and come in different shapes, lengths, widths and forms. The dentist can in theory choose among more than 2,000 implants in a given patient treatment situation. Implants made from titanium and titanium alloys appear to perform well clinically in properly surgically prepared bone, regardless of small variations of shapes and forms. Various surface treatments are currently being developed to improve the capacity of a more rapid anchorage of the implant into bone. A substantial number of claims made by different manufacturers on alleged superiority due to design characteristics are not based on sound and long-term clinical scientific research. Implants are, in some parts of the world, manufactured and sold with no demonstration of adherence to any international standards. CONCLUSIONS: The scientific literature does not provide any clear directives to claims of alleged benefits of specific morphological characteristics of dental implants.

Clinical Trials as Topic↗
PubMed2002

Characteristics of the surface oxides on turned and electrochemically oxidized pure titanium implants up to dielectric breakdown: the oxide thickness, micropore configurations, surface roughness, crystal structure and chemical composition.

Titanium implants have been used widely and successfully for various types of bone-anchored reconstructions. It is believed that properties of oxide films covering titanium implant surfaces are of crucial importance for a successful osseointegration, in particular at compromized bone sites. The aim of the present study is to investigate the surface properties of anodic oxides formed on commercially pure (c.p.) titanium screw implants as well as to study 'native' oxides on turned c.p. titanium implants. Anodic oxides were prepared by galvanostatic mode in CH3COOH up to the high forming voltage of dielectric breakdown and spark formation. The oxide thicknesses, measured with Auger electron spectroscopy (AES), were in the range of about 200-1000 nm. Barrier and porous structures dominated the surface morphology of the anodic film. Quantitative morphometric analyses of the micropore structures were performed using an image analysis system on scanning electron microscopy (SEM) negatives. The pore sizes were < or = 8 microm in diameter and had 1.27-2.1 microm2 opening area. The porosity was in the range of 12.7-24.4%. The surface roughness was in the range of 0.96-1.03 microm (Sa), measured with TopScan 3D. The crystal structures of the titanium oxide were amorphous, anatase, and a mixtures of anatase and rutile type, as analyzed with thin-film X-ray diffractometry (TF-XRD) and Raman spectroscopy. The chemical compositions consisted mainly of TiO2, characterized with X-ray photoelectron spectroscopy (XPS). The native (thermal) oxide on turned implants was 17.4 nm (+/- 6.2) thick and amorphous. Its chemical composition was TiO2. The surface roughness had an average height deviation of 0.83 microm (Sa). The present results are needed to elucidate the influence of the oxide properties on the biological reaction. The results of animal studies using the presently characterized surface oxides on titanium implants will be published separately.

Crystallography, X-Ray↗