Investigating the effect of blood-implant interactions on the response of soft tissue cells to titanium implants

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ICE Krakow

ICE Krakow

ul. Marii Konopnickiej 17 30-302 Kraków


Lackington, William Arthur (Empa)


Titanium-based dental implants have been highly optimized to enhance osseointegration, but little attention has been given to the soft tissue-implant interface, despite being a major contributor to long term implant stability. This is strongly linked to a lack of model systems that enable the reliable evaluation of soft tissue-implant interactions. Current in vitro platforms to assess these interactions are very simplistic, thus suffering from limited biological relevance and sensitivity to varying implant surface properties. The aim of this study was to investigate how blood-implant interactions affect downstream responses of different soft tissue cells to implants in vitro, thus taking into account not only the early events of blood coagulation upon implantation, but also the multicellular nature of soft tissue. For this, three surfaces (smooth and hydrophobic; rough and hydrophobic; rough and hydrophilic with nanostructures), which reflect a wide range of implant surface properties, were used to study blood-material and cell-material interactions, in the presence and absence of blood. While rough surfaces stimulated denser fibrin network formation compared to smooth surfaces, hydrophilicity accelerated the rate blood coagulation compared to hydrophobic surfaces. In the absence of blood, smooth surfaces supported enhanced attachment of human gingival fibroblasts and keratinocytes, while limited changes in gene expression and cytokine production were observed between surfaces. In the presence of blood, rough surfaces supported enhanced fibroblast attachment and stimulated a stronger anti-inflammatory response from macrophages than smooth surfaces, but only smooth surfaces were capable of supporting long-term keratinocyte attachment and formation of an epithelial layer. These findings indicate that surface properties govern blood-implant interactions, which in turn can significantly modulate the subsequent cell-implant interaction.

This research was funded by Innosuisse – Swiss Innovation Agency (SOFT 40048.1 IP-LS)

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