Polymers, in general, and Poly (Ether-Ether-Ketone) (PEEK) have emerged as potential alternatives to conventional osseous implant biomaterials. Due to its distinct advantages over metallic implants, PEEK has been gaining increasing attention as a prime candidate for orthopaedic and dental implants. However, PEEK has a highly hydrophobic and bioinert surface that attenuates the differentiation and proliferation of osteoblasts and leads to implant failure. Several improvements have been made to the osseointegration potential of PEEK, which can be classified into three main categories: (1) surface functionalization with bioactive agents by physical or chemical means; (2) incorporation of bioactive materials either as surface coatings or as composites; and (3) construction of three-dimensionally porous structures on its surfaces. The physical treatments, such as plasma treatments of various elements, accelerated neutron beams, or conventional techniques like sandblasting and laser or ultraviolet radiation, change the micro-geometry of the implant surface. The chemical treatments change the surface composition of PEEK and should be titrated at the time of exposure. The implant surface can be incorporated with a bioactive material that should be selected following the desired use, loading condition, and antimicrobial load around the implant. For optimal results, a combination of the methods above is utilized to compensate for the limitations of individual methods. This review summarizes these methods and their combinations for optimizing the surface of PEEK for utilization as an implanted biomaterial.
1 May 2023 in The International Journal of Prosthodontics
Purpose: To comparatively evaluate the amount of wear of natural enamel against a glazed full coverage monolithic zirconia crown and a polished monolithic zirconia crown at 6 and 12 months. Materials and Methods: Thirty subjects within the age range of 18 to 35 years participated in this study. The subjects received a total of 60 single crowns, which were divided into two groups: (1) 30 glazed monolithic zirconia crowns opposed by natural enamel (group A); and (2) 30 polished monolithic zirconia crowns opposed by natural enamel (group B). Each subject received a crown from both groups, placed bilaterally in endodontically treated maxillary or mandibular first molars. An impression was made of the opposing arch at 24 hours, 6 months, and 12 months. The resulting casts were scanned with a 3D optical scanner. The recall scans were superimposed and compared to baseline scans using 3D AutoCAD software. A control group was included to compare the wear values to natural enamel against natural enamel. Results: No significant difference (P = .855) was found in enamel wear between groups A (42.80 μm) and B (42.50 μm) after 6 months of use. However, a significant difference (P < .05) in enamel wear was found between group A (81.87 μm) and group B (71.43 μm) after 12 months of use. Conclusion: Glazed monolithic zirconia crowns cause more wear to the opposing enamel than polished monolithic zirconia crowns after 12 months of clinical use.
Innovation in the healthcare profession to solve complex human problems has always been emulated and based on solutions proven by nature. The conception of different biomimetic materials has allowed for extensive research that spans several fields, including biomechanics, material sciences, and microbiology. Due to the atypical characteristics of these biomaterials, dentistry can benefit from these applications in tissue engineering, regeneration, and replacement. This review highlights an overview of the application of different biomimetic biomaterials in dentistry and discusses the key biomaterials (hydroxyapatite, collagen, polymers) and biomimetic approaches (3D scaffolds, guided bone and tissue regeneration, bioadhesive gels) that have been researched to treat periodontal and peri-implant diseases in both natural dentition and dental implants. Following this, we focus on the recent novel application of mussel adhesive proteins (MAPs) and their appealing adhesive properties, in addition to their key chemical and structural properties that relate to the engineering, regeneration, and replacement of important anatomical structures in the periodontium, such as the periodontal ligament (PDL). We also outline the potential challenges in employing MAPs as a biomimetic biomaterial in dentistry based on the current evidence in the literature. This provides insight into the possible increased functional longevity of natural dentition that can be translated to implant dentistry in the near future. These strategies, paired with 3D printing and its clinical application in natural dentition and implant dentistry, develop the potential of a biomimetic approach to overcoming clinical problems in dentistry.
Dental implants, recognized for their enhanced functionality and aesthetic outcomes, are susceptible to peri‐implant mucositis and subsequent peri‐implantitis when oral hygiene is inadequate. Effective biofilm management is critical to prevent and manage these prevalent conditions and promote implant longevity. Materials with a two‐dimensional (2D) structure have demonstrated robust antimicrobial properties. Among these, 2D magnesium phosphates have garnered significant attention due to their additional biocompatibility and osteoconductive properties. This case series explores the application of a thixotropic inorganic hydrogel, composed of 2D magnesium phosphate, in the surgical treatment of dental implant infections. The hydrogel was used for surgical dental implant decontamination in patients diagnosed with peri‐implantitis characterized by inflammation in the peri‐implant mucosa and subsequent progressive loss of supporting bone. The study encompassed eight cases with a history of peri‐implantitis. Clinical measurements were recorded before and after treatment, including bleeding on probing, suppuration, and probing depth. Radiographic evaluations were conducted to assess the exposure of implant threads. The findings revealed a statistically significant decrease in probing depth, bleeding on probing, and the number of exposed implant threads following treatment with the magnesium phosphate hydrogel, though the exact role of the hydrogel in these improvements warrants further exploration.
1 January 2021 in International Journal of Applied Dental Sciences
Clinical crown of the tooth is the distance from gingival margin to incisal edge or occlusal surface of the tooth. Crown lengthening is a surgical procedure designed to increase the extent of the supragingival tooth structure, so that the clinician can restore the tooth. The crown lengthening procedure (CLP) is commonly used to maintain the dentogingival complex in optimal conditions and to correct aesthetic defects through a smile design. CLP in an anterior aesthetic driven region could be challenging. Hence, a multidisciplinary approach for better surgical and prosthetic outcomes should be practised. The current case report emphasises the need for prostho-perio interdisciplinary approach while restoring anterior esthetics and function.