The role of biomaterial interactions in peri-implantitis
File(s)
Author(s)
Barrak, Fadi
Type
Thesis
Abstract
Dental implant treatment for the replacement of missing teeth has become mainstream in the dental industry today. The increase in the number of implants placed has also presented an increase in the number of complications seen in practice, such as peri-implantitis. Possible causes of peri-implantitis include foreign body reaction to implant particles released in the adjacent tissues, or bacterial invasion due to weak connective tissue attachments to implants. The aim of this PhD is to investigate particle release from implant fixtures and their potential effects on local cells in vitro and bioactive glass S53P4 (SiO2 53.8 mol%, Na2O 22.70 mol%, CaO 21.80 mol%, P2O5 1.70 mol%) as a potential substrate for achieving collagen attachment with a view to develop a clinically applicable modification to the implant abutment.
In vitro investigations of commonly used titanium alloys revealed significant toxicity and increased inflammatory response from local cell lines to grade 5 titanium alloy particles when compared to grade 4, Roxolid® (Ti15Zr) and zirconia. An ex vivo study confirmed particle release during implant insertion from all test implants, which was significantly higher with grade 5 tapered implants. Grade 5 particles demonstrated an ability to influence macrophage polarity towards the M1 phenotype. When the particles were cultured with S53P4 bioactive glass dissolution product the inflammatory response to grade 5 particles from local cell lines was suppressed and the macrophage polarity was affected towards the M2 phenotype. This indicates a potential anti-inflammatory property of S53P4 not previously described. An initial investigation of S53P4 as a potential substrate for collagen attachment was carried out using scanning electron microscopy (SEM) imaging. Further studies on the anti-inflammatory properties and collagen attachment on S53P4 are needed to understand the mechanism of cellular response to S53P4 and to identify its possible clinical application as a substrate on dental implants.
In vitro investigations of commonly used titanium alloys revealed significant toxicity and increased inflammatory response from local cell lines to grade 5 titanium alloy particles when compared to grade 4, Roxolid® (Ti15Zr) and zirconia. An ex vivo study confirmed particle release during implant insertion from all test implants, which was significantly higher with grade 5 tapered implants. Grade 5 particles demonstrated an ability to influence macrophage polarity towards the M1 phenotype. When the particles were cultured with S53P4 bioactive glass dissolution product the inflammatory response to grade 5 particles from local cell lines was suppressed and the macrophage polarity was affected towards the M2 phenotype. This indicates a potential anti-inflammatory property of S53P4 not previously described. An initial investigation of S53P4 as a potential substrate for collagen attachment was carried out using scanning electron microscopy (SEM) imaging. Further studies on the anti-inflammatory properties and collagen attachment on S53P4 are needed to understand the mechanism of cellular response to S53P4 and to identify its possible clinical application as a substrate on dental implants.
Version
Open Access
Date Issued
2023-04-13
Date Awarded
01/01/2024
Advisor
Jones, Julian
Publisher Department
Materials
Publisher Institution
Imperial College London
Qualification Level
Doctoral
Qualification Name
Doctor of Philosophy (PhD)