In recent years, cold atmospheric plasma (CAP) technologies have received increasing attention in the field of biomedical applications. The aim of this article is to review the currently available literature to provide an overview of the scientific principles of CAP application, its features, functions, and its applications in systemic and oral diseases, with a specific focus on its potential in implantology. In this narrative review, PubMed, Medline, and Scopus databases were searched using key words like “cold atmospheric plasma”, “argon plasma”, “helium plasma”, “air plasma”, “dental implants”, “implantology”, “peri-implantitis”, “decontamination”. In vitro studies demonstrated CAP’s potential to enhance surface colonization and osteoblast activity and to accelerate mineralization, as well as to determine a clean surface with cell growth comparable to the sterile control on both titanium and zirconia surfaces. The effect of CAP on biofilm removal was revealed in comparative studies to the currently available decontamination modalities (laser, air abrasion, and chlorhexidine). The combination of mechanical treatments and CAP resulted in synergistic antimicrobial effects and surface improvement, indicating that it may play a central role in surface “rejuvenation” and offer a novel approach for the treatment of peri-implantitis. It is noteworthy that the CAP conditioning of implant surfaces leads to an improvement in osseointegration in in vivo animal studies. To the best of our knowledge, this is the first review of the literature providing a summary of the current state of the art of this emerging field in implantology and it could represent a point of reference for basic researchers and clinicians interested in approaching and testing new technologies.
No well-established evidence supporting safe use of bisphosphonates (BPs) or other antiresorptive agents prior, during, or after dentoalveolar surgery, are currently available; moreover, the real risk of osteonecrosis of the jaw (ONJ) development is still unknown. The aim of the present systematic review was to assess the scientific literature concerning the implants placement in antiresorptive agent users and the related risk of implants failure and ONJ development. English papers published from January 2003 until December 2014 were identified on the MEDLINE database. Titles and abstracts retrieved form electronic search were screened separately by 2 examiners; thus, original studies dealing with dental implants placement during or before bone antiresorptive agent therapy and the relative risk of implant failure or development of osteonecrosis were evaluated. Due to the heterogeneity of the included studies and the high risk of bias, there is no evidence of the safe use of oral antiresorptive agents prior or after dental implant surgery. Indeed, implant failure and ONJ development can occur and represent a devastating side effect that should be considered during treatment. Within the limitation of the present systematic review, high quality studies are needed to provide an adequate level of evidence regarding the safety of dentoalveolar surgery during or before bone resorption inhibition therapy and the increase predisposition to osteonecrosis of the jaw (ONJ) development. Therefore, antiresorptive agent therapy should be considered a risk factor until further evidence is prospectively obtained.
9 February 2016 in Journal of Biomedical Materials Research Part B: Applied Biomaterials
Purpose: The aim of the present in vitro study was to evaluate the leakage observed for 2 different microbial species at the level of the implant–abutment (I-A) interface, and the marginal fit and size of microgap at the I-A interface in 2 different implant connections. Methods: Ten specimens of each group were tested. The inner parts of 5 implants per group were inoculated with 0.1 μL of a viable Enterococcus faecalis suspension and 5 implants per group with Aggregatibacter actinomycetemcomitans. All of the vials containing the control specimens were incubated at 37°C under aerobic condition for E. faecalis and 37°C in presence of 5% CO2 for A. actinomycetemcomitans. They were maintained for 14 days, and the possible penetration of bacterial suspension into the surrounding solution was determined by the observation of turbidity of the broth. The I-A interface was evaluated for size of microgap and measured under SEM. Five implants of each group were evaluated. The marginal fit between implant and abutment was measured at 8 random locations in each assembly, under different magnifications at the interface. Results: No leakages through the I-A interface were demonstrated for either type of connection evaluated. The microgap values of all I-A interfaces ranged from 0.008 to 2.009 μm; the differences between the 2 systems were statistically significant. Conclusions: The present study demonstrated that a good marginal fit of implant components seemed to be able to prevent bacterial leakage.
This in vitro study aimed at evaluating the physical and mechanical properties of newly developed scaffolds of poly (lactic-co-glycolic acid) (PLGA) and biphasic ceramic (Hydroxyapatite HA + beta-tricalciumphosphate β-TCP) with or without collagen impregnation to be used for bone regeneration in the oral and maxillofacial district. Solvent casting and particle leaching techniques were used to produce the scaffolds, which were then divided into six groups according to PLGA/HA + β-TCP ratio and impregnation with collagen: G1 (50/50) + collagen; G2 (60/40) + collagen; G3 (40/60) + collagen; G4 (50/50); G5 (60/40); G6 (40/60). As control group, inorganic xenogenous bone was used. Structure and porosity were evaluated by scanning electron microscopy, and a chemical analysis was performed through an energy-dispersive spectrometer. Moreover, to evaluate the hydrophilicity of the samples, a wettability test was conceived, and finally, mechanical properties were examined by a compression test. High porosity and interconnectivity, resulting in a large surface area and great fluid retention capacity, were presented by the PLGA/HA + β-TCP scaffolds. In the composite groups, collagen increased the wettability and the mechanical resistance, although the latter was not statistically affected by the percentage of HA + β-TCP added. Further in vitro and in vivo studies are needed for a deeper understanding of the influence of collagen on the biological behavior of the developed composite materials and their potential, namely biocompatibility and bioactivity, for bone tissue regeneration.