The impact of cigarette smoking on periodontal disease and treatment

Orthopaedic and dental implants have become a staple of the medical industry and with an ageing population and growing culture for active lifestyles, this trend is forecast to continue. In accordance with the increased demand for implants, failure rates, particularly those caused by bacterial infection, need to be reduced. The past two decades have led to developments in antibiotics and antibacterial coatings to reduce revision surgery and death rates caused by infection. The limited effectiveness of these approaches has spurred research into nano-textured surfaces, designed to mimic the bactericidal properties of some animal, plant and insect species, and their topographical features. This review discusses the surface structures of cicada, dragonfly and butterfly wings, shark skin, gecko feet, taro and lotus leaves, emphasising the relationship between nano-structures and high surface contact angles on self-cleaning and bactericidal properties. Comparison of these surfaces shows large variations in structure dimension and configuration, indicating that there is no one particular surface structure that exhibits bactericidal behaviour against all types of microorganisms. Recent bio-mimicking fabrication methods are explored, finding hydrothermal synthesis to be the most commonly used technique, due to its environmentally friendly nature and relative simplicity compared to other methods. In addition, current proposed bactericidal mechanisms between bacteria cells and nano-textured surfaces are presented and discussed. These models could be improved by including additional parameters such as biological cell membrane properties, adhesion forces, bacteria dynamics and nano-structure mechanical properties. This paper lastly reviews the mechanical stability and cytotoxicity of micro and nano-structures and materials. While the future of nano-biomaterials is promising, long-term effects of micro and nano-structures in the body must be established before nano-textures can be used on orthopaedic implant surfaces as way of inhibiting bacterial adhesion.

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Bio-mimicking nano and micro-structured surface fabrication for antibacterial properties in medical implants.

Titanium (Ti) is broadly used for clinical purposes in various medical fields related to bone repair because of its favorable mechanical properties and its ability to osseointegrate in host bone tissue. Nowadays, Ti surfaces can be functionalized in order to provide potentially beneficial additional properties. In this review, we summarize different surface modifications of Ti implants, focusing on biological relevance and the biological issues targeted by each specific approach. We first define the historical relevance of Ti as an implantable material, the osseointegration process, and the main complications related to it before describing the biological rationale which motivates Ti surface modification in implantable devices. Then, we explore a variety of physical and chemical modifications feasible on Ti surfaces. Thereafter, we focus on inorganic and organic coatings being developed for implantable Ti devices that are currently under investigation. Finally, we summarize the surface-modification approa...

Titanium Coatings and Surface Modifications: Toward Clinically Useful Bioactive Implants

Background: Rheumatoid arthritis (RA) and periodontitis are both chronic inflammatory disease which demonstrate similarities in terms of mechanism, histopathology and demography. An association between these conditions has been demonstrated previously but has been called into question more recently. Methods: The published databases MEDLINE, EMBASE and PsycINFO were searched using search terms related to RA and periodontitis. Articles were selected if they included data on the number of people with RA diagnosed with periodontitis (or periodontal disease parameters) compared to a control comparison group. Review articles, case reports, animal model studies, non-English language and articles with unavailable abstracts were excluded. Data was extracted, critically appraised using the Downs and Black tool and a random effect Mantel-Haenszel meta-analysis was performed. Results: 21 papers met the eligibility criteria and provided data for the meta-analysis; 17 studies (including a total of 153,492 participants) comparing RA to healthy controls and 4 (including a total of 1378 participants) comparing RA to osteoarthritis (OA). There was a significantly increased risk of periodontitis in people with RA compared to healthy controls (RR: 1.13; 95% CI: 1.04, 1.23; p=0.006; N: 153,277) with a significantly raised mean probing depth, risk of bleeding on probing (BOP) and absolute value of clinical attachment loss in those with rheumatoid arthritis. When comparing RA and OA, there was no significant difference in the prevalence of periodontitis, however the risk of BOP was greater in OA than RA. Conclusion: The significant association between RA and periodontitis is supported by the results of our systematic review and meta-analysis of studies comparing RA to healthy controls. In our meta-analysis, however, this is not replicated when comparing RA to OA controls.

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Hand to Mouth: A Systematic Review and Meta-Analysis of the Association between Rheumatoid Arthritis and Periodontitis.

Periodontitis and smoking: an evidence-based appraisal.

This review covers several basic methodologies of surface treatment and their effects on titanium (Ti) implants. The importance of each treatment and its effects will be discussed in detail in order to compare their effectiveness in promoting osseointegration. Published literature for the last 18 years was selected with the use of keywords like titanium dental implant, surface roughness, coating, and osseointegration. Significant surface roughness played an important role in providing effective surface for bone implant contact, cell proliferation, and removal torque, despite having good mechanical properties. Overall, published studies indicated that an acid etched surface-modified and a coating application on commercial pure titanium implant was most preferable in producing the good surface roughness. Thus, a combination of a good surface roughness and mechanical properties of titanium could lead to successful dental implants.

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Surface Modifications and Their Effects on Titanium Dental Implants

Background Smoking has been associated with increased risk of periodontitis. The aim of the present study was to compare the periodontal disease severity of adult heavy smokers and never-smokers referred for assessment and treatment of chronic periodontitis. Methods A random sample of patients with at least 20 teeth, stratified for smoking and age (5-year blocks, 35 to 55 years), was selected from an original referral population of 1,221 subjects with chronic adult periodontitis. Adequate records for 59 never-smokers and 44 subjects who smoked at least 20 cigarettes per day were retrieved. The percentage of alveolar bone support was measured from dental panoramic radiographs with a Schei ruler at x3 magnification with the examiner unaware of the smoking status. Probing depths at six sites per tooth were obtained from the initial consultation. Results There was no significant difference in age between groups. Smokers had fewer teeth (p<0.001), fewer shallow pockets (p<0.001) and more deep probing depths (p<0.001). The differences were greater in subjects 45 years of age and over. In this age group, smokers had approximately 13% more bone loss, 15% more pockets in the 4-6 mm category and 7% more pockets in the ≥ 7 mm category than the never-smokers. Conclusions This study confirmed that smokers had evidence of more severe periodontal disease than never-smokers. The differences increased with age confirming an exposure-related response.

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A retrospective study of periodontal disease severity in smokers and non-smokers.

Synthesis and characterization of CaFe2O4 nanoparticles via co-precipitation and auto-combustion methods

The calcium ferrite nano-particles (CaFe2O4 NPs) were synthesized using a sol-gel method for targeted drug delivery application. The proposed nano-particles were initially prepared by mixing calcium and iron nitrates that were added with citric acid in order to prevent agglomeration and subsequently calcined at a temperature of 550°C to obtain small particle size. The prepared nanoparticles were characterized by using an XRD (X-ray diffraction), which revealed the configuration of orthorhombic structures of the CaFe2O4 nano-particles. A crystallite size of ~13.59 nm was obtained using a Scherer's formula. Magnetic analysis using a VSM (Vibrating Sample Magnetometer analysis), revealed that the synthesized particles exhibited super-paramagnetic behavior having magnetization saturation of approximately 88.3emu/g. Detailed observation via the scanning electron microscopy (SEM) showed the calcium ferrite nano-particles were spherical in shape.

Masfueh Razali

Papers

Surface Modifications and Their Effects on Titanium Dental Implants

A retrospective study of periodontal disease severity in smokers and non-smokers.

Synthesis and characterization of CaFe2O4 nanoparticles via co-precipitation and auto-combustion methods

Superparamagnetic calcium ferrite nanoparticles synthesized using a simple sol-gel method for targeted drug delivery.

Optimization of pH and dispersant amount of Y-TZP suspension for colloidal stability