Titanium (Ti) dental implants have been widely used for prosthetic reconstruction of dentition. Unfortunately, peri-implantitis can result in failure of dental implant osseointegration. Lipopolysaccharide (LPS) acts as a chronic inflammatory stimulus and maintains peri-implant inflammation, worsening the prognosis for implant osseointegration. The purpose of this study is to determine the effects of 10 M NaOH-modified Ti surface with nanonetwork structure on the proliferation and osteogenic differentiation of rat bone marrow mesenchymal stem cells (BMMSCs) in the context of Porphyromonas gingivalis LPS exposure. Methods: Titanium disks treated with 10 M NaOH solution and control were incubated with BMMSCs and exposed to P. gingivalis LPS (0, 0.1, or 1 mg/mL). The effects of the modified nanonetwork structure on osteogenic differentiation of rat BMMSCs were evaluated in the context of different concentrations of P. gingivalis LPS exposure. Results: Rat BMMSCs on the 10 M NaOH-modified Ti surface with nanonetwork structure had higher levels of osteogenesisrelated gene expression and significantly greater cell proliferation, alkaline phosphatase activity, and extracellular matrix deposition and mineralization than cells on the untreated Ti surfaces, in all the groups with different doses of P. gingivalis LPS exposure. Conclusion: The 10 M NaOH-modified Ti surface with nanonetwork structure has better endotoxin tolerance under P. gingivalis LPS exposure than the non-modified surface.
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