J Periodontal Implant Sci.  2016 Dec;46(6):362-371. 10.5051/jpis.2016.46.6.362.

Biocompatibility study of lithium disilicate and zirconium oxide ceramics for esthetic dental abutments

• Brunot-Gohin C
• Duval JL
• Verbeke S
• Belanger K
• Pezron I
• Kugel G
• Laurent-Maquin D
• Gangloff S
• Egles C

• KMID: 2362902
• DOI: http://doi.org/10.5051/jpis.2016.46.6.362

Abstract

PURPOSE
The increasing demand for esthetically pleasing results has contributed to the use of ceramics for dental implant abutments. The aim of this study was to compare the biological response of epithelial tissue cultivated on lithium disilicate (LSâ‚‚) and zirconium oxide (ZrOâ‚‚) ceramics. Understanding the relevant physicochemical and mechanical properties of these ceramics will help identify the optimal material for facilitating gingival wound closure.
METHODS
Both biomaterials were prepared with 2 different surface treatments: raw and polished. Their physicochemical characteristics were analyzed by contact angle measurements, scanning white-light interferometry, and scanning electron microscopy. An organotypic culture was then performed using a chicken epithelium model to simulate peri-implant soft tissue. We measured the contact angle, hydrophobicity, and roughness of the materials as well as the tissue behavior at their surfaces (cell migration and cell adhesion).
RESULTS
The best cell migration was observed on ZrOâ‚‚ ceramic. Cell adhesion was also drastically lower on the polished ZrOâ‚‚ ceramic than on both the raw and polished LS2. Evaluating various surface topographies of LS2 showed that increasing surface roughness improved cell adhesion, leading to an increase of up to 13%.
CONCLUSIONS
Our results demonstrate that a biomaterial, here LS2, can be modified using simple surface changes in order to finely modulate soft tissue adhesion. Strong adhesion at the abutment associated with weak migration assists in gingival wound healing. On the same material, polishing can reduce cell adhesion without drastically modifying cell migration. A comparison of LS2 and ZrO2 ceramic showed that LS2 was more conducive to creating varying tissue reactions. Our results can help dental surgeons to choose, especially for esthetic implant abutments, the most appropriate biomaterial as well as the most appropriate surface treatment to use in accordance with specific clinical dental applications.

Keyword

Ceramics; Dental abutments; Dental esthetics; Embryo culture techniques

MeSH Terms

Biocompatible Materials
Cell Adhesion
Cell Movement
Ceramics*
Chickens
Dental Abutments*
Dental Implants
Embryo Culture Techniques
Epithelium
Esthetics, Dental
Hydrophobic and Hydrophilic Interactions
Interferometry
Lithium*
Microscopy, Electron, Scanning
Surgeons
Tissue Adhesions
Wound Healing
Wounds and Injuries
Zirconium*
Biocompatible Materials
Dental Implants
Lithium
Zirconium

Figure

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  Figure 1 (A) Organotypic culture description. (B) Method of measurement of cell migration and adhesion. Thx, Thermanox®.

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  Figure 2 Physicochemical analyses of raw-LD, pol-LD, raw-Zr, and pol-Zr compared to Thx. (A) Contact angle θ (°); (B) Ra (μm); (C) images of water droplets; (D) interferometry microscopy images. Error bars indicate significant differences. raw-Zr, raw ZrO2 ceramic sample; pol-Zr, polished ZrO2 ceramic sample; raw-LD, raw LS2 ceramic sample; pol-LD, polished LS2 ceramic sample; Thx, Thermanox®; ns, not significant; Ra, roughness. a)Statistically significant differences (P<0.001).

• 

  Figure 3 Organotypic culture on raw-LD, pol-LD, raw-Zr, and pol-Zr compared to Thx. (A) Cell migration (mm2); (B) cell adhesion (arbitrary unit). Error bars indicate significant differences. raw-Zr, raw ZrO2 ceramic sample; pol-Zr, polished ZrO2 ceramic sample; raw-LD, raw LS2 ceramic sample; pol-LD, polished LS2 ceramic sample; Thx, Thermanox®; ns, not significant. a)Statistically significant differences (P<0.001).

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  Figure 4 Scanning results of raw-LD, pol-LD, raw-Zr, and pol-Zr compared to Thx. (A) White-light interferometry measuring the area with neutral red staining using imaging software (×12); and (B, C) scanning electron microscopy showing shapes and layers of cells (B, ×50; C, ×1,000). raw-Zr, raw ZrO2 ceramic sample; pol-Zr, polished ZrO2 ceramic sample; raw-LD, raw LS2 ceramic sample; pol-LD, polished LS2 ceramic sample; Thx, Thermanox®.

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