Abstract
Osseointegration is the backbone of successful implant stability. Biological ageing of titanium implants decreases its bioactivity leading to less bone to implant contact. Ultraviolet photofunctionalization reverses the ageing process, increases the bone-implant contact to almost 100% in what is known as “Superosseointegration”, and therefore increasing the strength and the primary stability of implants while decreasing the healing time. Photofunctionalization was shown to improve the prognosis, decreased morbidity and to have a significant impact on clinical practice. The aim of this review is to explain the events on the molecular level, the clinical implications of photofunctionalization and to highlight some of the other applications associated with this new technology.
Highlights
OI is the “direct structural and functional connection between ordered living bone and the surface of the load - covering implant at the histological level [1,2,3]
Osseointegration is a prerequisite for primary implant stability and is by far the most important factor to consider before establishing any further treatment [3]
The formed fibrin matrix acts as a scaffold for colonisation of the migrating and differentiation of osteogenic cells such as osteoblasts and the recruited mesenchymal stem cells (MSCs) arriving as early as the first day
Summary
The process of bone formation involves attachment, settlement, proliferation, and maturation of osteoblasts followed by mineralisation around the secreted proteins [4]. The formed fibrin matrix acts as a scaffold for colonisation of the migrating and differentiation of osteogenic cells such as osteoblasts and the recruited mesenchymal stem cells (MSCs) arriving as early as the first day. Upon arrival of these osteoprogenitor cells, matrix formation and mineralisation initiates by contact osteogenesis [2,3]. Despite exhibiting better biocompatible nature and less foreign body reaction compared to other conventional materials [3,6] pure titanium and titanium alloys were found to have good mechanical reliability, high corrosion resistance, as well as exhibiting low modulus of elasticity and considerable fatigue strength [7,8]. Surface modification approaches have been focused on making it more osteoinductive in order to stimulate and recruit osteogenic cells and to exhibit contact osteogenesis [10]
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