Dental Implant Surface

Dental implant surface options

Dental implant surfaces are changing as more and more companeis try new things to slightly increase the success or BIC of their dental implants.

Flow chart of some dental implant surfacesOptions for dental implant surfaces
Statement paper on different surfaces Aljateeli 2013 Implant Dentistry
  1. HA and Calcium phosphate – material helps in early bone formation
  2. Grit blasted – Al2O or TiO2 should acid etch after to remove particles
  3. Acid etched – dual etch used
  4. Oxidized surface – increase thickness of oxide layer helps significantly
  5. SLA treatment good

Dental implant surface abbreviations

DAE=Dual Acid etched=HCl and sulfuric acid
SAE=sand blasted alumina particles and acid etched
SLA=sand blasted large grit and acid etched
AO=anodic oxidation
CO=carbon oxygen ion treatment

Background information on titanium dental implants

TiO2 layer and crystalline structure important. 4nm layer spontaneous when exposed to air  3 phases

  • anatase
  • rutile=hydrophilic=large contact angle
  • brookite

Photofunctionalization of dental implants

Photofunctionalization changes TiO2 to the anatase form. This is super-hydrophilic and removes contaminations. It is also possible that there are oxygen vacancies on the surface as the surface changes from Ti4+ to Ti3+.

UV treatment converts Ti surface from hydrophobic to super-hydrophilic and removes contaminated hydrocarbons. Funato 2013 AACD   Ogawa 2014 JOMI Roy 2016
Works for orthodontic miniscrew too Tabuchi AJO Aug 2015 uses TheraBeam Super Osseo for 12 min
UV treatment increase BIC by generation super-hydrophilicity, decrease surface hydrocarbons, and improvement electrostatic surface Funato and Ogawa 2013
UV treatment had less crestal bone loss Kim JOMI 2022
Cut early implant failure loss in half using TheraBeam Affinty by Ushio for 15 minutes Hirota JOMI 2018
Suppresses oral bacteria attachment and biofilm formation. Ishijima JOMI 2019

Steps for photofunctionalization

There are multiple protocols for this in the literature. Some times are much shorter than others.

UVC  (λ= 250 ± 20 nm) with a 15W Philips lamp for 48 hours. Liu 2019 JOI has a great reference section as well.

 

Dental implant surface Research

Electrochemical anodization helps too? Lin 2012 Implant Dentistry
Osstem GSII I beleive is an ecample. Jeong 2012 Implant Dentistry
Fluoride surface no different BIC to anodized Choi 2012 Implant Dentistry

poly(D,L-lactide-co-glycolide) (PLGA) solution mixed with 1α,25-diydroxyvitamin D3 (1α,25-(OH)2D3) via an electrospray technique MAY stimulate bone growth Choi 2011 JOMI

CO BIC >SAE, DAE, AO
SB, DAE, BIC>SAE
BUT AO=SAE=DAE same in survival Sesma 2012 JOMI

AO>DAE,SBA for contact angle and removal torque rabbit Elias 2008

 

Medications, drugs, and additives that increase the bodies ability to osseointegrate.

The main medication seen in literature is the statin family. Both local and systemic use seem to improve osseointegration. A systemic review of the statin topic from Kellesarian in JOMI 2017 confirms this. Interestingly, statins also appear to help teeth heal better from root canals. I will bet that biological medications adalimumab (Humira) and infliximab (Remicade) will also help, since they help with bone healing in root canal teeth.

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