Influence of Surface Texture of Implants on Microorganism – A Review

BACKGROUND The development of endosseous osseointegrated dental implants has been very rapid over the past 20 years. The present literature review focuses on evaluating the various modifications done on the surface of dental implant and its influence on microorganisms. We wanted to review the evidence on the surface texture of implants and its influence on microorganisms. METHODS A Medline research was done, and all the information was gathered from various research articles. The keywords on the search pad were “implant”, “surface texture”, “surface modifications “, “biofilm”, “bacterial attachment”, “adhesion”, “microbes”, “antibacterial”, “acid etching”, “subtractive” and “additive” changes. The research publications were searched on Google Scholar and PubMed. Screening of studies which were eligible for the review, quality assessment, inclusion criteria, exclusion criteria and data extraction for all the endosseous implants with various surface modifications were checked. Verification of the information was conducted by two reviewers independently to eliminate any bias. The review article included systemic analysis, retrospective study and randomised trials. The results were all initially tabulated comparing the surface modifications with their effect on implant including bacterial resistance, osteogenic, osteoconductive etc. Based on the evidence the results were formulated, and the conclusion was made. RESULTS It’s clear from the evidence that there was no constancy in the results obtained. Each study believes in different techniques and different ideologies of the researcher to improve the microbial resistance either by coating or by surface modification. Due to the varying pattern of results, it is difficult to identify a definite reason for the microbial load over the implant. CONCLUSIONS There was no constancy in the results obtained. Overall, there are many technical solutions to avoid implant failure due to the bacterial load. These technical solutions exhibit a great potential when tried on preclinical models but there is a lack of clinical trial which hinders the achievement of any proper conclusion to build a standard protocol for the manufacturing of dental implants with structural modification. As implants are considered to be the most effective way to replace a missing tooth, standard technique with better surface texture is required to have good strength and better microbial resistance. KEY WORDS Surface Texture, Implant, Biofilm, Microbial Load, Modifications, Antimicrobial, Osseoconductive, Osseointegration

Download Full-text

Impact of Dental Implant Surface Modifications on Osseointegration

BioMed Research International ◽

10.1155/2016/6285620 ◽

2016 ◽

Vol 2016 ◽

pp. 1-16 ◽

Cited By ~ 177

Author(s):

Ralf Smeets ◽

Bernd Stadlinger ◽

Frank Schwarz ◽

Benedicta Beck-Broichsitter ◽

Ole Jung ◽

...

Keyword(s):

Dental Implants ◽

Survival Rates ◽

Surface Modifications ◽

Comprehensive Overview ◽

Implant Surface ◽

Oral Rehabilitation ◽

New Techniques ◽

Surface Design ◽

Dental Implant Surface ◽

Experimental Surface

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.

Download Full-text

Surface Modification of Dental Implants - A Review

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/265 ◽

2021 ◽

Vol 10 (17) ◽

pp. 1246-1250

Author(s):

Shamaa Anjum ◽

Arvina Rajasekar

Keyword(s):

Surface Roughness ◽

Surface Modification ◽

Dental Implants ◽

Surface Engineering ◽

Surface Modifications ◽

Calcium Phosphate Coating ◽

Acid Etching ◽

Success Rates ◽

Implant Surface ◽

Osteoblast Activity

The use of dental implants for the replacement of missing teeth has increased in the last 30 years. The success rates for implant placement depend on a series of both biological and clinical steps which starts with primary stability that is being provided by the amount, quality and the distribution of bone within the proposed implant site. The most important factor in implant osseointegration is surface roughness, which shows increased osteoblast activity at 1 to 100 μm of the surface roughness when compared to a smooth surface. Rough surfaces have excellent osseointegration than smooth surfaces, but the results of research have been diverse, and it is evident that multiple treatments provide good results. The surfaces of a dental implant have been modified in several ways to improve its biocompatibility and speed up osseointegration. Literature says that any surface modification provides a good surface for osseointegration of the implant when the surface roughness is about 0.44 ~ 8.68 μm. It is also said that acid etching and coating are the most preferred methods for creating good roughness of the implant surface. From animal studies, it is known that implant surface modifications provided by biomolecular coating seemed to enhance the osseointegration by promoting peri-implant bone formation in the early stages of healing. It also seemed to improve histomorphometric analysis and biomechanical testing results. This article reviews the surface modifications of dental implants for the achievement of better success rates. Various methods are used to modify the topography or the chemistry of the implant surfaces which includes acid etching, anodic oxidation, blasting, treatment with fluoride, and calcium phosphate coating. These modifications provide a faster and a stronger osseointegration.1 Recently, hydrophilic properties added to the roughened surfaces or some osteogenic peptides coated on the surfaces shows higher biocompatibility and have induced faster osseointegration compared to the existing modified surfaces. With development in surface engineering techniques, new information on the properties, behaviour, and the reaction of various materials could be discovered which in turn allows the discovery of new materials, modification techniques and design of bio implants for the future. KEY WORDS Dental Implants, Surface Modifications, Biocompatibility, Surface Topography

Download Full-text

The Impact of Dental Implant Surface Modifications on Osseointegration and Biofilm Formation

Journal of Clinical Medicine ◽

10.3390/jcm10081641 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1641

Author(s):

Stefanie Kligman ◽

Zhi Ren ◽

Chun-Hsi Chung ◽

Michael Angelo Perillo ◽

Yu-Cheng Chang ◽

...

Keyword(s):

Dental Implant ◽

Biofilm Formation ◽

Bacterial Colonization ◽

Surface Modifications ◽

Implant Surface ◽

Oral Rehabilitation ◽

Surface Design ◽

Polyether Ether Ketone ◽

Dental Implant Surface ◽

The Impact

Implant surface design has evolved to meet oral rehabilitation challenges in both healthy and compromised bone. For example, to conquer the most common dental implant-related complications, peri-implantitis, and subsequent implant loss, implant surfaces have been modified to introduce desired properties to a dental implant and thus increase the implant success rate and expand their indications. Until now, a diversity of implant surface modifications, including different physical, chemical, and biological techniques, have been applied to a broad range of materials, such as titanium, zirconia, and polyether ether ketone, to achieve these goals. Ideal modifications enhance the interaction between the implant’s surface and its surrounding bone which will facilitate osseointegration while minimizing the bacterial colonization to reduce the risk of biofilm formation. This review article aims to comprehensively discuss currently available implant surface modifications commonly used in implantology in terms of their impact on osseointegration and biofilm formation, which is critical for clinicians to choose the most suitable materials to improve the success and survival of implantation.

Download Full-text

Macrophagic Inflammatory Response Next to Dental Implants with Different Macro- and Micro-Structure: An In Vitro Study

Applied Sciences ◽

10.3390/app11125324 ◽

2021 ◽

Vol 11 (12) ◽

pp. 5324

Author(s):

Maria Menini ◽

Francesca Delucchi ◽

Domenico Baldi ◽

Francesco Pera ◽

Francesco Bagnasco ◽

...

Keyword(s):

Inflammatory Response ◽

Dental Implants ◽

In Vitro Study ◽

Titanium Implants ◽

Implant Surface ◽

Bone Implant ◽

Optimal Outcomes ◽

Negative Controls ◽

Inflammatory Effect

(1) Background: Intrinsic characteristics of the implant surface and the possible presence of endotoxins may affect the bone–implant interface and cause an inflammatory response. This study aims to evaluate the possible inflammatory response induced in vitro in macrophages in contact with five different commercially available dental implants. (2) Methods: one zirconia implant NobelPearl® (Nobel Biocare) and four titanium implants, Syra® (Sweden & Martina), Prama® (Sweden & Martina), 3iT3® (Biomet 3i) and Shard® (Mech & Human), were evaluated. After 4 h of contact of murine macrophage cells J774a.1 with the implants, the total RNA was extracted, transcribed to cDNA and the gene expression of the macrophages was evaluated by quantitative PCR (qPCR) in relation to the following genes: GAPDH, YWHAZ, IL1β, IL6, TNFα, NOS2, MMP-9, MMP-8 and TIMP3. The results were statistically analyzed and compared with negative controls. (3) Results: No implant triggered a significant inflammatory response in macrophages, although 3iT3 exhibited a slight pro-inflammatory effect compared to other samples. (4) Conclusions: All the samples showed optimal outcomes without any inflammatory stimulus on the examined macrophagic cells.

Download Full-text

Calcium Phosphate-Coated Titanium Implants in the Mandible: Limitations of the in vivo Minipig Model

European Surgical Research ◽

10.1159/000513846 ◽

2020 ◽

Vol 61 (6) ◽

pp. 177-187

Author(s):

Till Kämmerer ◽

Tony Lesmeister ◽

Victor Palarie ◽

Eik Schiegnitz ◽

Andrea Schröter ◽

...

Keyword(s):

Calcium Phosphate ◽

Statistical Difference ◽

Surface Modifications ◽

Titanium Implants ◽

In Vivo Model ◽

Implant Surface ◽

Press Fit ◽

Endosseous Implant ◽

Bone To Implant Contact

Introduction: We aimed to compare implant osseointegration with calcium phosphate (CaP) surfaces and rough subtractive-treated sandblasted/acid etched surfaces (SA) in an in vivo minipig mandible model. Materials and Methods: A total of 36 cylindrical press-fit implants with two different surfaces (CaP, n = 18; SA, n = 18) were inserted bilaterally into the mandible of 9 adult female minipigs. After 2, 4, and 8 weeks, we analyzed the cortical bone-to-implant contact (cBIC; %) and area coverage of bone-to-implant contact within representative bone chambers (aBIC; %). Results: After 2 weeks, CaP implants showed no significant increase in cBIC and aBIC compared to SA (cBIC: mean 38 ± 5 vs. 16 ± 11%; aBIC: mean 21 ± 1 vs. 6 ± 9%). Two CaP implants failed to achieve osseointegration. After 4 weeks, no statistical difference between CaP and SA was seen for cBIC (mean 54 ± 15 vs. 43 ± 16%) and aBIC (mean 43 ± 28 vs. 32 ± 6). However, we excluded two implants in each group due to failure of osseointegration. After 8 weeks, we observed no significant intergroup differences (cBIC: 18 ± 9 vs. 18 ± 20%; aBIC: 13 ± 8 vs. 16 ± 9%). Again, three CaP implants and two SA implants had to be excluded due to failure of osseointegration. Conclusion: Due to multiple implant losses, we cannot recommend the oral mandibular minipig in vivo model for future endosseous implant research. Considering the higher rate of osseointegration failure, CaP coatings may provide an alternative to common subtractive implant surface modifications in the early phase post-insertion.

Download Full-text

The osseointegration and stability of dental implants with different surface treatments in animal models: a network meta-analysis

Scientific Reports ◽

10.1038/s41598-021-93307-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Chun-Ping Hao ◽

Nan-Jue Cao ◽

Yu-He Zhu ◽

Wei Wang

Keyword(s):

Dental Implants ◽

Early Stage ◽

Meta Analysis ◽

Critical Role ◽

Cochrane Library ◽

Missing Teeth ◽

Treatment Technology ◽

Implant Surface ◽

Randomized Controlled ◽

Early Healing

AbstractDental implants are commonly used to repair missing teeth. The implant surface plays a critical role in promoting osseointegration and implant success. However, little information is available about which implant surface treatment technology best promotes osseointegration and implant stability. The aim of this network meta-analysis was to evaluate the osseointegration and stability of four commonly used dental implants (SLA, SLActive, TiUnite, and Osseotite). The protocol of the current meta-analysis is registered in PROSPERO (International Prospective Register of Systematic Reviews) under the code CRD42020190907 (https://www.crd.york.ac.uk). We conducted a systematic review following PRISMA and Cochrane Recommendations. Medline (PubMed), Cochrane Library, Embase, and the Web of Science databases were searched. Only randomized controlled trials were considered. Twelve studies were included in the current network meta-analysis, eleven studies were included concerning the osseointegration effect and five studies were included for stability analysis (four studies were used to assess both stability and osseointegration). Rank possibility shows that the SLActive surface best promoted bone formation at an early healing stage and TiUnite seemed to be the best surface for overall osseointegration. For stability, TiUnite seemed to be the best surface. The present network meta-analysis showed that the SLActive surface has the potential to promote osseointegration at an early stage. The TiUnite surface had the best effect on osseointegration regarding the overall healing period. The TiUnite surface also had the best effect in stability.

Download Full-text