A new paradigm shift: from smooth to rough to hybrid implants - Opinion paper

Abstract

Implant therapy provides his survival rates while on the other hand the prevalence of peri-implantitis became a concern in the last 20 years. With the lack of enough longterm (>20 years) studies it’s still uncertain if the high survival rates achieved with the smooth Bränemark implants are transferable to the modern rough implants we use nowadays. Risk factors for peri-implantitis change over time in our patient groups and rough surfaces will be likely be exposed to the oral environment at a certain moment. There are alarming indications that exposed rough implants are more prone to peri-implantitis than smooth implants. Also treating peri-implantitis on a rough surface has been found much less predictable. This knowledge is used by different companies to develop a new group of implant surfaces, called hybrid implants. Implants with an apical rough surface for optimal bone to implant contact and short healing periods and a smooth coronal parts for a safe soft tissue integration in case it ever will be exposed to the oral environment. In this article cases are shown that with hybrid implants complex cases can be treated with aesthetic outcomes. It is the start of a whole new era of implant surface development.