Influence of Surface Characteristics of TiO2 Coatings on the Response of Gingival Cells: A Systematic Review of In Vitro Studies

Abstract

The soft tissue-implant interface requires the formation of epithelium and connective tissue seal to hinder microbial infiltration and prevent epithelial down growth. Nanoporous titanium dioxide (TiO2) surface coatings have shown good potential for promoting soft tissue attachment to implant surfaces. However, the impact of their surface properties on the biological response of gingival cells needs further investigation. This systematic review aimed to investigate the cellular behavior of gingival cells on TiO2-implant abutment coatings based on in vitro studies. The review was performed to answer the question: “How does the surface characteristic of TiO2 coatings influence the gingival cell response in in vitro studies?”. A search in MEDLINE/PubMed and the web of science databases from 1990 to 2022 was performed using keywords. A quality assessment of the studies selected was performed using the SciRAP method. A total of 11 publications were selected from the 289 studies that fulfilled the inclusion criteria. The mean reporting and methodologic quality SciRAP scores were 82.7 ± 6.4/100 and 87 ± 4.2/100, respectively. Within the limitations of this in vitro systematic review, it can be concluded that the TiO2 coatings with smooth nano-structured surface topography and good wettability improve gingival cell response compared to non-coated surfaces.

Effect of TiO2 Abutment Coatings on Peri-Implant Soft Tissue Behavior: A Systematic Review of In Vivo Studies

“…The higher wettability, which represents the hydrophilic behavior of the nanostructure TiO 2 surface, promoted protein adsorption, encouraged cell adhesion and proliferation, and consequently enhanced connective tissue regeneration [ 29 , 30 ]. Furthermore, the author's previous in vitro review has shown that TiO 2 coatings with smooth surface topography and good wettability promote fibroblast and epithelial cell response compared with machined surfaces [ 31 ]. However, the outcomes of the present systematic review did not consistently align with these findings.…”

“…Several in vitro studies have demonstrated that nanoporous TiO 2 coatings enhanced gingival cell response [ 5 , 21 , 29 , 30 ]. It has been shown that nanostructured TiO 2 coatings with smooth surface topography and good wettability promote favorable fibroblast and epithelial cell responses compared to machined surfaces which ultimately affects the rate and quality of new tissue formation [ 31 ]. However, in vitro studies cannot truly represent the biological process of oral implant and abutment integration.…”