Dentistry
Year :
2012
| Month :
April
| Volume :
6
| Issue :
2
| Page :
319 - 324
Full Version
Implant Surface Modifications:
A Review
Published: April 1, 2012 | DOI: https://doi.org/10.7860/JCDR/2012/.1937
Hemlata Garg, Gaurav Bedi, Arvind Garg
1. Reader, School of Dental Sciences,
Sharda University Gr. Noida, India.
2. Reader, School of Dental Sciences, Sharda University Gr.
Noida,India
3. Associate Professor,
Krishna Dental College, Ghaziabad, India
Correspondence Address :
Dr. Hemlata Garg, C-5/1, Krishna Nagar, Delhi -51.
Phone: 9818504850
E-mail: drgarghemlata@gmail.com.
Abstract
The aim of the present review was to elaborate on the surface modifications of biomaterials which are used in implant dentistry. The ongoing studies on the clinical and laboratory phases and on the biomaterial sciences have largely aimed at invoking a stronger bone response and an earlier and longer functional loading. Surgical grafting procedures to improve the bone bed are used to create an ideal environment for the implant functioning. The implant selection which is based on the available bone, is also an important determiner of the long term clinical success. The interfacial zone between the implant and the bone is composed of a relatively thin layer (<100um) which consists of heterogenous metallic oxide, proteins and connective tissue. The integrity of the implant – tissue interface is dependent on the material and on mechanical, chemical, surface, biological and local environmental factors, all of which change as a function of time in vivo. Because a stable interface must be developed before the loading, it is desirable that the tissue apposition may be accelerated to the implant surface. The material developments that have been implemented in the clinical practice include the use of surface roughened implants and bioactive ceramic coatings. Osseointegration occurs around the screw threaded implants through the tissue ongrowth or through a direct apposition between the tissue and the implant surface. The alternative methods of the implant-tissue attachments, based on the tissue ingrowth into roughened or three dimensional surface layers, yield a higher bone metal shear strength and decreased implant loosening. A positive effect of various surface modifications which are illustrated in this review, has been observed and suggested by many groups.
Keywords
Hydrophilic surface Laser etching Nanotitania Osseointegration Aniodized implants Biotolerant
Introduction
An implant is a medical device which is made from one or more biomaterials, that is intentionally placed in the body either totally or that is partially buried beneath an epithelial surface (1). Osseointegration is the foundation of implant sciences and infinite articles have been published on the various aspects of manufacturing the implants and on the clinical and laboratory phases of implants. The implant machining, surface, designing, surgical techniques and the peri-implant considerations have all progressed from infancy to the state of art and science and continue to evolve with each passing year. The surface characteristics at the micro or nanometre level, hydrophilicity, biochemical bonding and other features are few of the determiners which are responsible for the implant’s success (2).
Osseointegration per se is not linked to certain defined surface characteristics, since a great number of different surfaces achieve osseointegration. However, the stronger or weaker bone responses may be related to the surface phenomenon (2). The bone implant interface can be controlled by the selection and modification of the biomaterial from which is made. These include morphological, physiochemical and biochemical methods. The morphological methods involve alterations in the surface morphology and roughness, such as hydroxyapatite coating or blasting and etching. The physiochemical methods involve modification of the surface energy, the surface charge and the surface composition. The biochemical surface modification endeavours to utilize the current understanding of the biology and the biochemistry of the cellular function and differentiation (3). The biomaterials which are used most commonly for the dental implants are metals and their alloys, namely commercially pure titanium (1-4grades) and titanium alloys like Ti-6Al-4V, which are used most commonly as endosseous implants. The metallic implants undergo modifications such as passivation, anodization, ion implantation and texturing (4). Our aim was to review the surface modifications of the titanium based implants, some of the techniques of the modifications and the newer formulations.
Conclusion
Some studies (41) support the hypothesis that in case of a favourable bone quality implant, the surface roughness plays a minor role. A positive influence of the moderate rough surfaces on the early loading concepts has been suggested by many groups. A positive effect of the surface roughness has been observed in poor quality bone, but the pivotal proof of this effect is still lacking, according to some studies. Some indications which support the selection of HA coated implants over metallic implants include, the need for a greater bone implant interface contact and the ability to be placed in type IV bone, fresh extraction sites and newly grafted sites (4).
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DOI and Others DOI: JCDR/2012/3642:1937
Financial OR OTHER COMPETING INTERESTS: None.
Date Of Submission: Nov 17, 2011 Date Of Peer Review: Jan 23, 2012 Date Of Acceptance: Jan 24, 2012 Date Of Publishing: Apr 15, 2012
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