Papers by Author: Petros Koidis

Abstract: When used as an implanted material, titanium (Ti) surface controls the subsequent biological reactions and leads to tissue integration. Cells interactions with the surface, through a protein layer that is being formed from the moment Ti surface comes in contact with blood and its components, and indeed this protein layer formation, are regulated by surface properties such as topography, chemistry, charge and surface energy. Currently, the implementation of nanotechnology, in an attempt to support mimicking the natural features of extracellular matrix, has provided novel approaches for understanding and translating surface mechanisms whose modification and tailoring are expected to lead to enhanced cell activity and improved integration. Despite the fact that there has been extensive research on this subject, the sequence of interactions that take place instantly after the exposure of the implanted material into the biologic microenvironment are not well documented and need further investigation as well as the optimization of characteristics of Ti surface. This review, including theoretical and experimental studies, summarizes some of the latest advances on the Ti surface concerning modifications on surface properties and how these modifications affect biomolecular reactions and also attempts to present the initial adsorption mechanism of water and protein molecules to the surface.

Abstract: In most biphasic composite systems consisting of sol-gel derived bioactive glass and a second system that is usually used as a reinforcing agent, thorough stirring is necessary to prevent the precipitation of the grains of the second system. Consequently, the aim of this work is to investigate the impact of various stirring rates on the crystallinity and bioactivity of a bioactive glass in the system 58S. Sol-gel-derived bioactive glass (58S) was produced as described in literature. During the gelation, stirring rates of 0, 200, 400, 600 and 800 rpms were applied producing, respectively, the corresponding glass powders. The in vitro bioactivity of the powders was tested in Simulated Body Fluid (SBF) for various immersion times, while the solution was renewed after 6h, 24h and then every 2 days. Fourier Transform Infrared Spectroscopy (FTIR), Scanning Electron Microscopy (SEM) and X-ray Diffractometry (XRD) were used to characterize all materials before and after immersion in SBF solution. FTIR and XRD measurements of all powders revealed mainly the formation of an amorphous glass, while the main crystalline phase was identified to be Ca2SiO4. After immersion in SBF solution for 12h, SEM microphotographs revealed apatite formation on the surface of all samples, while FTIR and XRD confirmed the aforementioned findings. Furthermore, since EDS analysis proved a mean molar Ca/P ratio of about1.7 after 6 days of immersion of all samples- besides those stirred at 400 and 600rpm- it can be assumed that a thick apatite layer was formed covering the whole surface.

Abstract: Scaffold-based tooth engineering is currently the most popular approach towards replacing dental tissues or even engineering a bio-tooth. Although, various scaffold materials have been employed in tooth regeneration, the scaffold-based tooth design has, until now, achieved only limited success. Recently, bioactive Mg-based ceramics have attracted interest as Mg plays an important role on skeletal metabolism and affects the quality and structure of hard dental tissues. Mg has been reported to improve the mechanical properties of calcium phosphate ceramics, control biodegradation rate and stabilize the cell-material interface improving cell attachment and growth. The aim of this study was the development of an experimental Mg-based ceramic material, with enhanced bioactivity and adequate mechanical properties, in order to be potentially used in dental tissue regeneration. The Mg-based ceramic was prepared by the sol-gel method, while the stabilization was performed at 1300, 1400 and 1450oC in order a fully crystalline material to be obtained. The characterization of the materials -before and after immersion is Simulated Body Fluid (SBF)- was performed by Fourier Tranform Infrared Spectroscopy (FTIR), X-Ray Diffractometry (XRD) and Scanning Electron Microscopy associated with an EDS analyzer (SEM-EDS), while the flexural strength of uniaxially pressed pellets was measured using a universal testing machine for 3- point bending tests (Instron 3344). FTIR spectra and XRD patterns of all powder samples before immersion in SBF solution confirmed the presence of three crystalline phases; akermanite, merwinite and diopside. The onset of apatite formation on the surface of all powders was observed even after three days of immersion, while the apatite formation on the surface of the sintered pellets was slightly delayed. Flexural strength values were in the range of 30Mpa. In conclusion, Mg-based glass-ceramics attain adequate mechanical integrity and high rate of bioactivity and could be potentially used in the construction of ceramic scaffolds for dental tissue regeneration.

Abstract: Chitin is a polysaccharide abundant in nature. Its’ deacetylation product-chitosan- in combination with gelatin (collagen product) is commonly used as biopolymer scaffold for tissue engineering. The aim of this study was to investigate diffrerences in surface characteristics of chitin (CHN CCS) and chitosan –gelatin (CHS-G CCS) composite ceramic scaffolds (CCS), during their incubation in culture medium (DMEM) with or without human periodontal ligament fibroblasts (HPDLF). CHN CCS and CHS- G CCS, with pore size 70-200μm, were fabricated on the surface of ceramic disks, being coated with a mixture of bioactive glass – ceramic (1:1 wt). Three CCSs of each type were constructed. Each CCS was incubated at 37 °C up to 10 days, either only in DMEM supplemented with 10% FCS or in DMEM with the presence of 10⁵ HPDLF. SEM microphotographs and EDS analysis, before and after incubation, were used to investigate CCSs’ surface alterations. Before incubation, all type of CCSs appeared to be macro porous with high interconnectivity. Exposed to incubation, CHN CCSs’ surface porosity seemed to be rapidly reduced and a rough surface without pores was observed with or without HPDLF. Attached HPDLF were rarely detected. CHS-G CCSs appeared to retain surface porosity in DMEM without cells. In HPDLF culture an almost uniform surface with organic aggregates and attached cells was observed. Until day 10, HPDLF could only be detected at CHS-G CCS’s surface. Conclusion: SEM microphotographs observations indicate that CHN CCSs’ incubation in DMEM led in early and rapid coalescence of surface pores, thus inhibiting HPDLF attachment. HPDLF attachment on CHS-G CCSs confirm the beneficial role of gelatin, while differences in CHS-G CCSs’ surface with and without HPDLF culture indicate that not only sedimentation of medium's ingredients, but cell attachment and function could decrease surface’s porosity, affecting consequently HPDLF proliferation.

Abstract: End temperature of the firing cycle, during processing of dental ceramics, directs the interaction of both sintering and crystallization pathways, tailoring physicochemical properties and bioactivity. Thus, the purpose of the present study was to investigate the influence of end temperature over the structural properties and composition, along with the bioactive behavior of dental porcelain, modified by bioactive glass. Sol-gel derived specimens of bioactive glass (58S)- commercial dental porcelain composites synthesized (BP) and underwent firing cycles at the crystallization temperature (Tc=1040oC) and the temperature just below the melting range (Tm=1080oC), as the composite material. The recommended temperature for the commercial porcelain (Ta=930oC) was examined, too. All specimens were characterized using X-ray diffraction (XRD), Fourier Transform Infrared spectroscopy (FTIR), Scanning Electron Microscopy (SEM). The assessment of bioactivity was performed in vitro, via the detection of apatite layer development. The well-defined particles, observed by SEM, at 930oC, developed contact formation during the stage of neck growth at 1040oC and 1080oC, indicating the initiation of sintering process. Increasing temperature, the complex porei network became smoother, while spherical and closed porei were evident. FTIR revealed the predominance of wollastonite at the increased temperatures, along with the appearance of cristobalite, while XRD confirmed the results. Finally, the in vitro tests evidenced the bioactivity of the specimens independently of the final temperature, though the increased temperature caused delayed apatite layer formation on their surface. The, microstructural and chemical evolution of the studied composite is temperature-dependent. Increased temperature favored the sintering process initiation, along with the surface crystallization, which delays bioactivity.

Abstract: High strength of Yttria stabilized tetragonal zirconia polycrystal (Y-TZP) zirconia ceramics are sensitive to low temperature degradation (LTD) that leads to exaggerated tetragonal to monoclinic transformation and a surface to depth propagating degradation that diminishes their mechanical properties. In vitro tests for accelerating ageing have been proposed for the prediction of zirconia ceramics clinical performance. The aim of the present work was to investigate the in vitro ageing of a cold isostatic-pressed zirconia ceramic for all ceramic restorations. Bar-shaped specimens milled from a zirconia block (Ivoclar IPS e.max ZirCAD) were sintered to full density, mirror-polished and cut into two equal pieces. One piece was used as control while the other was subsequently aged (steam 134°C / 2 bars / 10 hours). Atomic Force Microscopy (AFM) was used to evaluate the surface profile and the micro-structural features before and after ageing. Fourier Transform Infrared Spectroscopy (FTIR) and X-Ray Diffraction Analysis (XRD) were used to determine the degree of the m-ZrO₂ transformation. Ageing resulted in an increase of the surface roughness, while the formation of monoclinic spots on the surface of the specimens was verified by surface uplifts in the AFM images. The peaks of the m-phase were clearly observed in the FTIR spectra while an average increase of 16% w.t. of the m-ZrO₂ phase was recorded by XRD. Although, no sound lifetime predictions can be made from accelerated tests, based on the ISO standard that imposes that the m-phase should not exceed 25% wt after 5h at 134 °C and 2 bar pressure , it can be concluded that the tested ceramic resisted an extreme transformation that could negatively affect its clinical performance.

Abstract: The aim of this study was the fabrication using a sol-gel technique of a new glass-ceramic with potential use in dental applications. The characterization of the composition and microstructural properties of the produced material confirmed the similarity between the new sol-gel derived glass-ceramic and a commercial leucite based fluorapatite dental glass-ceramic. The produced material has potential application in dental restorations and it is expected to exhibit better control of composition, microstructure and properties due to the intrinsic advantages of the sol-gel preparation method.

Abstract: Sol-gel derived glasses have been reported to express considerably higher bioactivity than melt-derived ones. The use of the sol-gel method for the fabrication of dental ceramic bioactive glass composites has resulted in composites consisting of an amorphous glassy network into which crystals of Calcium Silicate (CS), Wollastonite (W), leucite (Lt) and Fluorapatite (FAp) are dispersed. Thus, the aim of the present study was the investigation of the bioactivity of sol-gel derived dental ceramic/bioactive glass composites, in the form of powders and in thermally treated disk shaped specimens. Fourier Transform Infrared Spectroscopy (FTIR) and Scanning Electron Microscopy (SEM) were used to characterize the reacted products. The sol-gel derived dental glass ceramic composites present high bioactivity compared to the respective melt-derived ones, which is attributed to the higher CaO content and the crystallization of bioactive W and CS crystal phases during the fabrication process. However, the powdered samples presented faster HCAp formation compared to the respective specimens, due to their higher surface energy.

Abstract: In this study new ternary bioactive mixtures were investigated, which are appropriate for applications as coatings on the surface of dental ceramics. The fabrication of mixtures based on the combination of dental ceramic, hydroxyapatite and bioactive glass was demonstrated. The mixtures were characterized by FTIR, XRD and SEM and their bioactive behavior was investigated by immersion in Simulated Body Fluid (SBF). The ternary mixture consisted of a high fusing leucite-feldspathic dental ceramic which exhibited the highest bioactive behavior assigned to the characteristic crystal phases occurring under the specific heat treatment investigated.

Abstract: Melt derived bioactive glass- porcelain system is reported to be bioactive but with a slow rate of bioactivity. The aim of this work is to fabricate and characterize bioactive glass/dental porcelain composites produced by the sol-gel method. Fourier Transform Infrared Spectroscopy (FTIR), Scanning Electron Microscopy (SEM) and X-ray Diffractometry (XRD) were used to characterize the fabricated materials. The FTIR spectra and the XRD patterns confirm the presence of both constituents in the mixtures, while the dominant crystal phases in bioactive glass/dental porcelain specimens are leucite and wollastonite.