Dental implant bioactive surface modifications and their effects on osseointegration: a review

Abstract

BackgroundThe purpose of this article is to review and update the current developments of biologically active dental implant surfaces and their effect on osseointegration.MethodsPubMed was searched for entries from January 2006 to January 2016. Only in-vivo studies that evaluated the effects of biomolecular coatings on titanium dental implants inserted into the bone of animals or humans were included.ResultsThirty four non-review studies provided data and observations were included in this review. Within the criteria, four categories of biomolecular coatings were evaluated. The potential biomolecules include bone morphogenetic proteins in 8 articles, other growth factors in 8 articles, peptides in 5 articles, and extracellular matrix in 13 articles. Most articles had a healing period of 1 to 3 months and the longest time of study was 6 months. In addition, all studies comprised of implants inserted in animals except for one, which evaluated implants placed in both animals and humans. The results indicate that dental implant surface modification with biological molecules seem to improve performance as demonstrated by histomorphometric analysis (such as percentage of bone-to-implant contact and peri-implant bone density) and biomechanical testing (such as removal torque, push-out/pull-out tests, and resonance frequency analysis).ConclusionsBioactive surface modifications on implant surfaces do not always offer a beneficial effect on osseointegration. Nevertheless, surface modifications of titanium dental implants with biomolecular coatings seem to promote peri-implant bone formation, resulting in enhanced osseointegration during the early stages of healing. However, long-term clinical studies are needed to validate this result. In addition, clinicians must keep in mind that results from animal experiments need not necessarily reflect the human clinical reality.

Neuronal PAS domain 2 (Npas2) facilitated osseointegration of titanium implant with rough surface through a neuroskeletal mechanism

“…The os seointegration of Ti-implants was initially explained by the establishment of direct bone to implant connection without a layer of soft tissue encapsulation owing to relatively inert Ti biomaterials [4]. However, surface functionalization of Ti implants has been shown to improve and accelerate the osseointegration process includes moderately rough surface topography [5] and nanotopography [6,7], increasing surface energy [8,9] as well as incorporating bone inductive biological molecules [10]. The outcome of these functionalization technologies suggest that Ti-biomaterials with a complex surface can induce biological reactions leading to the establishment of enhanced osseointegration, although the underlying mechanisms are not yet fully understood.…”

Biomechanical, histological, and computed X‐ray tomographic analyses of hydroxyapatite coated PEEK implants in an extended healing model in rabbit

“…31 Surface topography is one of the dependent factors to establish osseointegration according to Wennerberg and Albrektsson. 33 The coating procedure used in this study altered the surface roughness at the nanometer level but also improved the bioactive appearance. 33 The coating procedure used in this study altered the surface roughness at the nanometer level but also improved the bioactive appearance.…”

A Newly Created Meso-, Micro-, and Nano-Scale Rough Titanium Surface Promotes Bone-Implant Integration

“…The micron-scale topography of a titanium surface is commonly created by acid-etching, sandblasting, or a combination of both [16]. In addition, the micro-roughness of titanium alloys has also been reported [17].…”