• The Journal of Korean Academy of Prosthodontics
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• v.42 no.3
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• pp.307-326
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• 2004

Statement of problem. The long-term success of implants is the development of a stable direct connection between bone and implant surface, which must be structural and functional. To improve a direct implant fixation to the bone, various strategies have been developed focusing on the surface of materials. Among them, altering the surface properties can modify cellular responses such as cell adhesion, cell motility and bone deposition. Purpose. This study was to evaluate the cellular behaviors on the surface-modified titanium by morphological observation, cellular proliferation and differentiation. Material and methods. Specimens were divided into five groups, depending on their surface treatment: electropolishing(EP) anoclizing(AN), machining(MA), blasting with hydroxyapatite particle(RBM) and electrical discharge machining(EDM). Physicochemical properties and microstructures of the specimens were examined and the responses of osteoblast-like cells were investigated. The microtopography of specimens was observed by scanning electron microscopy(SEM). Surface roughness was measured by a three-dimensional roughness measuring system. The microstructure was analyzed by X-ray diffractometer(XRD) and scanning auger electron microscopy(AES). To evaluate cellular responses to modified titanium surfaces, osteoblasts isolated from neonatal rat were cultured. The cellular morphology and total protein amounts of osteoblast-like cell were taken as the marker for cellular proliferation, while the expression of alkaline phosphatase was used as the early differentiation marker for osteoblast. In addition, the type I collagen production was determined to be a reliable indicator of bone matrix synthesis. Results. 1. Each prepared specimen showed specific microtopography at SEM examination. The RBM group had a rough and irregular pattern with reticulated appearance. The EDM-treated surface had evident cracks and was heterogeneous consisting of broad sheet or plate with smooth edges and clusters of small grains, deep pores or craters. 2. Surface roughness values were, from the lowest to the highest, electropolished group, anodized group, machined group, RBM group and EDM group. 3. All groups showed amorphous structures. Especially anodized group was found to have increased surface oxide thickness and EDM group had titaniumcarbide(TiC) structure. 4. Cells on electropolished, anodized and machined surfaces developed flattened cell shape and cells on RBM appeared spherical and EDM showed both. After 14 days, the cells cultured from all groups were formed to be confluent and exhibited multilayer proliferation, often overlapped or stratified. 5. Total protein amounts were formed to be quite similar among all the group at 48 hours. At 14 days, the electropolished group and the anodized group induced more total protein amount than the RBM group(P<.05). 6. There was no significant difference among five groups for alkaline phosphatase(ALP) activity at 48 hours. The AN group showed significantly higher ALP activity than any other groups at 14 days(P<.05). 7. All the groups showed similar collagen synthesis except the EDM group. The amount of collagen on the electropolished and anodized surfaces were higher than that on the EDM surface(P<.05).

• Journal of Periodontal and Implant Science
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• v.42 no.2
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• pp.59-63
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• 2012

Purpose: This study evaluated the surface characteristics and bond strength produced using a novel technique for coating hydroxyapatite (HA) onto titanium implants. Methods: HA was coated on the titanium implant surface using a super-high-speed (SHS) blasting method with highly purified HA. The coating was performed at a low temperature, unlike conventional HA coating methods. Coating thickness was measured. The novel HA-coated disc was fabricated. X-ray diffraction analysis was performed directly on the disc to evaluate crystallinity. Four novel HA-coated discs and four resorbable blast medium (RBM) discs were prepared. Their surface roughnesses and areas were measured. Five puretitanium, RBM-treated, and novel HA-coated discs were prepared. Contact angle was measured. Two-way analysis of variance and the post-hoc Scheffe's test were used to analyze differences between the groups, with those with a probability of P<0.05 considered to be statistically significant. To evaluate exfoliation of the coating layer, 7 sites on the mandibles from 7 mongrel dogs were used. Other sites were used for another research project. In total, seven novel HA-coated implants were placed 2 months after extraction of premolars according to the manufacturer's instructions. The dogs were sacrificed 8 weeks after implant surgery. Implants were removed using a ratchet driver. The surface of the retrieved implants was evaluated microscopically. Results: A uniform HA coating layer was formed on the titanium implants with no deformation of the RBM titanium surface microtexture when an SHS blasting method was used. Conclusions: These HA-coated implants exhibited increased roughness, crystallinity, and wettability when compared with RBM implants.

• Journal of Periodontal and Implant Science
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• v.42 no.6
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• pp.248-255
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• 2012

Purpose: The aim of the present study was to evaluate the biological response of alkali- and heat-treated titanium-8tantalum-3niobium surfaces by cell proliferation and alkaline phosphatase (ALP) activity analysis. Methods: Commercial pure titanium (group cp-Ti) and alkali- and heat-treated titanium-8tantalum-3niobium (group AHT) disks were prepared. The surface properties were evaluated using scanning electron microscopy, energy dispersed spectroscopy and X-ray photoelectron spectroscopy (XPS). The surface roughness was evaluated by atomic force microscopy and a profilometer. The contact angle and surface energy were also analyzed. The biological response of fetal rat calvarial cells on group AHT was assessed by cell proliferation and ALP activity. Results: Group AHT showed a flake-like morphology microprofile and dense structure. XPS analysis of group AHT showed an increased amount of oxygen in the basic hydroxyl residue of titanium hydroxide groups compared with group cp-Ti. The surface roughness (Ra) measured by a profilometer showed no significant difference (P>0.05). Group AHT showed a lower contact angle and higher surface energy than group cp-Ti. Cell proliferation on group AHT surfaces was significantly higher than on group cp-Ti surfaces (P<0.05). In comparison to group cp-Ti, group AHT enhanced ALP activity (P<0.05). Conclusions: These results suggest that group AHT stimulates osteoblast differentiation.

• Journal of the Korean institute of surface engineering
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• v.57 no.4
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• pp.296-305
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• 2024

The aim of this in vitro study was to evaluate the changes in the roughness and weight of titanium discs treated with 3 different types of magnetostrictive ultrasonic scaler tip. Eighty identical disks (10 mm in diameter), 50 for surface roughness and 30 for weight change, were investigated in this study. For this study, 3 types of scaler tip were used as follows; Powerline(FSI-PWR-1000), Slimline(FSI-SLI-1000), and Thinsert(-16 00037374). The power was set to high power(HP), medium power(MP), and low power(LP), in the blue zone recommended by the manufacturer. Surface topography analysis was carried out using scanning electron microscopy (SEM). Surface roughness measurements, the average surface roughness (Ra) and mean roughness profile depth (Rz), were compared between treated and non-treated surfaces with a profilometer. A PowerLINE-MP of magnetostrictive ultrasonic scalers for implant patients might be recommended when considering changes in the roughness and weight of titanium discs.

• The Journal of the Korean dental association
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• v.51 no.12
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• pp.643-649
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• 2013

The aim of this study was to achieve the healing of peri-implantitis defects and the hard tissue regeneration using the augmentation of a xenograft on defect site. Two patients were treated with the surgical approach. With a full muco-periosteal flap elevation, the implant surfaces were exposed and taken the debridement of granulation tissue around the abutment. Each surface of the abutments was prepared with the air-abrasive device (PerioFlow$^{(R)}$) for decontamination. Bovine-derived bone mineral (Bio-Oss collagen$^{(R)}$) was then used to fill the defects, and no membrane was placed on the grafting site. Radiographs and clinical photo was taken to compare from baseline status. Within the limits of the present case, this case shows the significance of the surgical treatment of peri-implantitis. And this also verifies the stability of bovine-derived bone mineral and effectiveness of Air-abrasive device (PerioFlow$^{(R)}$).

• The korean journal of orthodontics
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• v.41 no.4
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• pp.268-279
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• 2011

Objective: The purpose of this study was to compare self-drilling orthodontic mini-implants of different surfaces, namely, machined (untreated), etched (acid-etched), RBM (treated with resorbable blasting media) and hybrid (RBM + machined), with respect to the following criteria: physical appearance of the surface, measurement of surface roughness, and insertion pattern. Methods: Self-drilling orthodontic mini-implants (Osstem implant, Seoul, Korea) with the abovementioned surfaces were obtained. Surface roughness was measured by using a scanning electron microscope and surface-roughness-testing machine, and torque patterns and vertical loadings were measured during continuous insertion of mini-implants into artificial bone (polyurethane foam) by using a torque tester of the driving-motor type (speed, 12 rpm). Results: The mini-implants with the RBM, hybrid, and acid-etched surfaces had slightly increased maximum insertion torque at the final stage ($p$ < 0.05). Implants with the RBM surface had the highest vertical load for insertion ($p$ < 0.05). Testing for surface roughness revealed that the implants with the RBM and hybrid surfaces had higher Ra values than the others ($p$ < 0.05). Scanning electron microscopy showed that the implants with the RBM surface had the roughest surface. Conclusions: Surface-treated, self-drilling orthodontic mini-implants may be clinically acceptable, if controlled appropriately.

• Journal of Periodontal and Implant Science
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• v.52 no.4
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• pp.261-281
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• 2022

Purpose: Short implants are a potential alternative to long implants for use with bone augmentation in atrophic jaws. This meta-analysis investigated the survival rate and marginal bone level (MBL) of surface-modified short vs. long implants. Methods: Electronic and manual searches were performed for articles published between January 2010 and June 2021. Twenty-two randomized controlled trials (RCTs) comparing surface-modified short and long implants that reported the survival rate with at least 1 year of follow-up were selected. Two reviewers independently extracted the data, and the risk of bias and quality of evidence were evaluated. A quantitative meta-analysis was performed regarding survival rate and MBL. Results: The failure rates of surface-modified short and long implants differed significantly (risk ratio, 2.28; 95% confidence interval [CI], 1.46, 3.57; P<0.000). Long implants exhibited a higher survival rate than short implants (mean follow-up, 1-10 years). A significant difference was observed in mean MBL (mean difference=-0.43, 95% CI, -0.63, -0.23; P<0.000), favoring the short implants. Regarding the impact of surface treatment in short and long implants, for hydrophilic sandblasted acid-etched (P=0.020) and titanium oxide fluoride-modified (P=0.050) surfaces, the survival rate differed significantly between short and long implants. The MBL differences for novel nanostructured calcium-incorporated, hydrophilic sandblasted acid-etched, and dual acid-etched with nanometer-scale calcium phosphate crystal surfaces (P=0.050, P=0.020, and P<0.000, respectively) differed significantly for short vs. long implants. Conclusions: Short surface-modified implants are a potential alternative to longer implants in atrophic ridges. Long fluoride-modified and hydrophilic sandblasted acid-etched implants have higher survival rates than short implants. Short implants with novel nanostructured calcium-incorporated titanium surfaces, hydrophilic sandblasted acid-etched surfaces, and dual acid-etched surfaces with nanometer-scale calcium phosphate crystals showed less marginal bone loss than longer implants. Due to high heterogeneity, the MBL results should be interpreted cautiously, and better-designed RCTs should be assessed in the future.

• Journal of Periodontal and Implant Science
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• v.37 no.sup2
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• pp.427-445
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• 2007

To improve osseointegration at the boneto-implant interface, several studies have been carried out to modify titanium surface. Variations in surface texture or microtopography may affect the cellular response to an implant. Osteoblast-like cells attach more readily to a rougher titanium surface, and synthesis of extracellular matrix and subsequent mineralization were found to be enhanced on rough or porous coated titanium. However, regarding the effect of roughened surface by physical and mechanical methods, most studies carried out on the reactions of cells to micrometric topography, little work has been performed on the reaction of cells to nanotopography. The purpose of this study was to examme the response of osteoblast-like cell cultured on blasted surfaces and alkali treated surfaces, and to evaluate the influence of surface texture or submicro-scaled surface topography on the cell attachment, cell proliferation and the gene expression of osteoblastic phenotype using ROS 17/2.8 cell lines. In scanning electron micrographs, the blasted, alkali treated and machined surfaces demonstrated microscopic differences in the surface topography. The specimens of alkali treatment had a submicro-scaled porous sur-face with pore size about 200 nm. The blasted surfaces showed irregularities in morphology with small(<10 ${\mu}m$) depression and indentation among flatter-appearing areas of various sizes. Based on profilometry, the blasted surfaces was significantly rougher than the machined and the alkali treated surfaces (p$TiO_2$) were observed on alkali treated surfaces, whereas not observed on machined and blasted surfaces. The attachment morphology of cells according to time was observed by the scanning electron microscope. After 1 hour incubation, the cells were in the process of adhesion and spreading on the prepared surfaces. After 3 hours, the cells on all prepared surfaces were further spreaded and flattened, however on the blasted and alkali treated surfaces, the cells exhibited slightly irregular shapes and some gaps or spaces were seen. After 24 hours incubation, most cells of the all groups had a flattened and polygonal shape, but the cells were more spreaded on the machined surfaces than the blasted and alkali treated surfaces. The MTT assay indicated the increase on machined, alkali treated and blasted surfaces according to time, and the alkali treated and blasted surfaces showed significantly increased in optical density comparing with machined surfaces at 1 day (p<0.01). Gene expression study showed that mRNA expression level of ${\alpha}\;1(I)$ collagen, alkaline phosphatase and osteopontin of the osteoblast-like cells showed a tendency to be higher on blasted and alkali treated surfaces than on the machined surfaces, although no siginificant difference in the mRNA expression level of ${\alpha}\;1(I)$ collagen, alkaline phosphatase and osteopontin was observed among all groups. In conclusion, we suggest that submicroscaled surfaces on osteoblast-like cell response do not over-ride the one of the surface with micro-scaled topography produced by blasting method, although the microscaled and submicro-scaled surfaces can accelerate osteogenic cell attachment and function compared with the machined surfaces.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.3
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• pp.306-318
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• 2008

Anodic spark deposition method(ASD) surface treated titanium implant possesses a considerable osteoconductive potential that promoting a high level of implant osseointegration in normal bone. The purpose of this study was to observe the ASD implant's osseointegration in the osteoporosis-induced animal model. Twenty four rats, 10 weeks of age, were ovarectomized and 5 weeks later divided into two groups : ASD implant group and control implant group. Titanium screw implants (diameter; 2.0 mm, length, 3.5 mm; pitch-height, 0.4 mm) were designed for this study. Experimental implants were ASD treated and no treatment on control implants. ASD implants and control implants were placed in to left tibiae of rats. The rats were sacrificed at different time interval(1, 2, 4 and 8 weeks after implantation) for histopathologic observation and immunohisto-chemistrical observation, with collagen type Ⅰ, fibronectin, integrin ${\alpha}_2{\beta}_1$ and integrin ${\alpha}_5{\beta}_1$ antibodies. The results obtained from this study were as follow: 1. Histopathologic findings, overall tissue response and the pattern of bone formation in both groups were similar. In ASD group, more newly formed bone was seen at 1 week and 2weeks than control group. 2. The levels of type Ⅰ collagen and fibronectin expression were the most abundant at 2weeks and decreased gradually in both groups. Fibronectin and type Ⅰ collagen expression in ASD group were stronger than control group but no significance. 3. The levels of integrin ${\alpha}_2{\beta}_1$ and Integrin ${\alpha}_5{\beta}_1$ expression were most abundant at 2 weeks and decreased gradually in both groups. No significant difference was observed in both groups. From this results, anodic oxidized titanium implants were more advantages in early stage of bone formation than control group, but have no significance in tissue responses and late bone formations. It could be stated that although anodic oxidized titanium implant possesses considerable osteoconductive potential but in osteoporotic bone condition dental implant procedure should performed after improving or treating the osteoporotic bone condition.

• Journal of Dental Rehabilitation and Applied Science
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• v.24 no.4
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• pp.361-369
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• 2008

The purpose of this study is to make porous oxide film on the surfaces of pure Ti through anodic spark discharge in electrolytic solution containing calcium and phosphate ions, to improve osseointergration by treating fluoride agent. In addition, it is to evaluate the fluoride modified effect on the surface. Commercial pure Ti plate with $20{\times}10{\times}2mm$ and Ti wire with a diameter of 1.5mm and a total length of 15mm were used. After making titanium oxide films converted by anodic spark discharge, anodizing was performed. Fluoride was spreaded to titanium laboratory plate and maintained for 30 minutes after anodizing breakdown. Fluoride ion discharge amount was measured per 24 hours after dipping titanium plate into saline (10ml) and sustaining 90rpm in a pyrostat. Some plates and wires were dipped in Hanks solutions for a month to examine biocompatibility using SEM and XRD. $TiO_2$ film formed by anodic discharge technique showed great roughness and uniform pores which were $1{\sim}3{\mu}m$ in a diameter. Roughness of the films treated with anodic discharge after blasting were higher than the turned ones(P<0.05). Rapid surface activity was observed in the samples treated with $TiF_3$ agent, which immersed in Hanks solution for 30 days. Taking the results into consideration, the fluoride modified implant with anodic discharge demonstrates that it makes uniformly porous oxide film on the surface of implant and properly increase roughness for osseointegration. The implants will achieve greater bone integration after short healing time by improving surface activity.