Impact of Dental Implant Surface Modifications on Osseointegration

Abstract

Objective. The aim of this paper is to review different surface modifications of dental implants and their effect on osseointegration. Common marketed as well as experimental surface modifications are discussed. Discussion. The major challenge for contemporary dental implantologists is to provide oral rehabilitation to patients with healthy bone conditions asking for rapid loading protocols or to patients with quantitatively or qualitatively compromised bone. These charging conditions require advances in implant surface design. The elucidation of bone healing physiology has driven investigators to engineer implant surfaces that closely mimic natural bone characteristics. This paper provides a comprehensive overview of surface modifications that beneficially alter the topography, hydrophilicity, and outer coating of dental implants in order to enhance osseointegration in healthy as well as in compromised bone. In the first part, this paper discusses dental implants that have been successfully used for a number of years focusing on sandblasting, acid-etching, and hydrophilic surface textures. Hereafter, new techniques like Discrete Crystalline Deposition, laser ablation, and surface coatings with proteins, drugs, or growth factors are presented. Conclusion. Major advancements have been made in developing novel surfaces of dental implants. These innovations set the stage for rehabilitating patients with high success and predictable survival rates even in challenging conditions.

Implant stability in the posterior maxilla: a controlled clinical trial

“…The concept of primary stability is related to the lack of mobility of the implant after its placement in the implant bed [13][14][15][16][17][18] and to the measurement of the consistency of bone/implant complex [15][16][17][18][19][20]. There are two types of implant stability: primary and secondary stability [18][19][20][21][22][23].…”

“…Secondary stability comes from regeneration and remodeling of the bone and tissue around the implant after insertion, and it mainly depends on the micro/nanotopographical features of the implant [13][14][15][16][17][18][22][23][24]; however, it seems to be highly dependent on the primary stability [10,22,23].…”

“…So far, several nondisruptive methods have been suggested to evaluate the implant stability, such as percussion tests, radiography, insertion torque (IT) measurement [12][13][14][15][16][17][18], and resonance frequency analysis (RFA) with the implant stability quotient (ISQ) scale [12][13][14][15][16][17][18]23]. Nowadays, the most objective and commonly used tests to measure primary stability are IT and RFA by means of ISQ measurements: the IT measures the rotational stability while the ISQ measures the axial stability of the implant [12,[18][19][20][21][22][23]. However, only the ISQ allows for the monitoring of the evolution of the fixture stability during healing time, from primary to secondary implant stability [13][14][15][16][17][18].…”

“…At placement, the stability is considered acceptable if comprised between 55 and 85 ISQ [4,[12][13][14][15][16][17][18][19]23], and higher values are generally found in the mandible rather than the maxilla [4,[12][13][14][15][16][17][18][19]23]. In all cases, a massive decrease in ISQ values indicates a potential problem at the boneimplant interface, and it should be considered as an early warning because it can be indicative of clinical problems that can lead to implant failure [12,[18][19][20][21][22][23]. In the first healing period, the implant stability usually slightly decreases, because remodeling processes affect the preexisting bone, responsible for the initial mechanical stabilization.…”

Delivery of antagomiR204-conjugated gold nanoparticles from PLGA sheets and its implication in promoting osseointegration of titanium implant in type 2 diabetes mellitus

“…1,11 However, simply having the surface handled with physical changes is not enough for patients with DM. Bone mesenchymal stem cells (BMSCs) are the key cell components responsible for osteogenesis.…”