Covalently-Linked Hyaluronan versus Acid Etched Titanium Dental Implants: A Crossover RCT in Humans.

Saturnino Lupi,Giorgio Iviglia,Marco Tallarico,Clara Cassinelli,Ruggero Rodriguez Y Baena,Arianna Rodriguez Y Baena,Marco Morra

doi:10.3390/ijms20030763

Saturnino Lupi, Giorgio Iviglia + Show 5 more

Open Access

https://doi.org/10.3390/ijms20030763

Copy DOI

Abstract

Biochemical modification of titanium surfaces (BMTiS) entails immobilization of biomolecules to implant surfaces in order to induce specific host responses. This crossover randomized clinical trial assesses clinical success and marginal bone resorption of dental implants bearing a surface molecular layer of covalently-linked hyaluronan in comparison with control implants up to 36 months after loading. Patients requiring bilateral implant rehabilitation received hyaluronan covered implants in one side of the mouth and traditional implants in the other side. Two months after the first surgery, a second surgery was undergone to uncover the screw and to place a healing abutment. After two weeks, the operator proceeded with prosthetic procedures. Implants were evaluated by periapical radiographs and the crestal bone level was recorded at mesial and distal sites—at baseline and up to 36 months. One hundred and six implants were positioned, 52 HY-coated, and 48 controls were followed up. No differences were observed in terms of insertion and stability, wound healing, implant success, and crestal bone resorption at any time considered. All interventions had an optimal healing, and no adverse events were recorded. This trial shows, for the first time, a successful use in humans of biochemical-modified implants in routine clinical practice and in healthy patients and tissues with satisfactory outcomes.

Highlights

Ever since the pioneering studies of Professor Brånemark, osseointegration of titanium implant fixtures has been recognized as an interfacial event [1]
The primary physical-chemical variables, titanium oxide surface chemistry, and implant surface topography dictate relevant surface parameters—such as surface charge and wettability—and have been deeply investigated in relation to cellular events leading to peri-implant bone regeneration [5,6,7,8,9,10,11]
In the present clinical trial, a widely adopted microrough titanium surface and the same surface further modified by a covalently-linked nanolayer of hyaluronan were compared in terms of clinical success in routine clinical practice

Summary

Introduction

Ever since the pioneering studies of Professor Brånemark, osseointegration of titanium implant fixtures has been recognized as an interfacial event [1]. The primary physical-chemical variables, titanium oxide surface chemistry, and implant surface topography dictate relevant surface parameters—such as surface charge and wettability—and have been deeply investigated in relation to cellular events leading to peri-implant bone regeneration [5,6,7,8,9,10,11]. The understanding of such relationships prompted the clinical evolution of titanium implants from the original turned to present day micro- and nano-rough surfaces [12,13,14].

Objectives

Methods

Discussion

Conclusion