Following implantation, dental implant stability can become compromised due to poor bone tissue integration and reactive foreign-body encapsulation. A key tenet of bone tissue engineering is biomimetic design, and in particular, the development of responsive surfaces that promote ion exchange with interfacing tissues, facilitating the ionic events that occur naturally during bone repair, hold promise as orthopedic fixation strategies. Herein, simple thermochemical and oxygen plasma processes are described and assessed in vivo as functional approaches for the development of dental implants with enhanced integration potential. Non-bioactive titanium dental implants treated by shot-blasting and acid-etching (AE) (to produce micro to nanoscale hierarchical topographic structure) induced higher bone implant contact (BIC=53% and 68%) compared to shot-blasted treated (SB) implants (BIC=47% and 49%) at weeks 4 and 8, respectively. Plasma (PL) or thermochemical (BIO) processes were subsequently used to produce a bioactive charged surface by selective ion adsorption as indicated by surface zeta potential changes from-34 mV (SB) to-20mV (PL) or-10 mV (BIO). In addition, an increase on the polar component of surface energy was obtained due to higher number of surface hydroxyl groups as indicated by X-ray photoelectron spectroscopy (XPS) and energy-dispersive X-ray spectroscopy analyses (EDX). In vivo results showed that charged implants exhibited enhanced osteoconductivity through ionic surface-tissue exchange (PL, BIC= 69% and 73% and BIO, BIC= 83% and 86 % at weeks 4 and 8 respectively). Furthermore, charged bioactive surfaces (PL and BIO) obtained functional mechanical stability as early as 4 weeks post implantation via increased total bone area (BAT=56% and 59%) ingrowth compared to SB (BAT=35%) and AE (BAT=35%) surfaces. This results correlated positively with clinical evaluation of osseointegration using resonance frequency analysis (RFA). This study describes the development and application of surface functionalization methods to selectively modulate surface charges and enhance implant-bone tissue integration.
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