Abstract
Surface chemistry and nanotopography of dental implants can have a substantial impact on osseointegration. The aim of this investigation was to evaluate the effects of surface chemistry and nanotopography on the osseointegration of titanium-zirconium (TiZr; Roxolid®) discs, using a biomechanical pull-out model in rabbits. Two discs each were placed in both the right and left tibiae of 16 rabbits. Five groups of sandblasted acid etched (SLA) discs were tested: (1) hydrophobic without nanostructures (dry/micro) (n = 13); (2) hydrophobic with nanostructures, accelerated aged (dry/nano/AA) (n = 12); (3) hydrophilic without nanostructures (wet/micro) (n = 13); (4) hydrophilic with nanostructures, accelerated aged (wet/nano/AA; SLActive®) (n = 13); (5) hydrophilic with nanostructures, real-time aged (wet/nano/RTA). The animals were sacrificed after four weeks and the biomechanical pull-out force required to remove the discs was evaluated. Adjusted mean pull-out force was greatest for group wet/nano/RTA (64.5 ± 17.7 N) and lowest for group dry/micro (33.8 ± 10.7 N). Multivariate mixed model analysis showed that the pull-out force was significantly greater for all other disc types compared to the dry/micro group. Surface chemistry and topography both had a significant effect on pull-out force (p < 0.0001 for both), but the effect of the interaction between chemistry and topography was not significant (p = 0.1056). The introduction of nanostructures on the TiZr surface significantly increases osseointegration. The introduction of hydrophilicity to the TiZr implant surface significantly increases the capacity for osseointegration, irrespective of the presence or absence of nanotopography.
Highlights
A sandblasted, large-grit, acid-etched surface has become one of the most extensively used surface for dental implants
The aim of this study was to assess any differences in surface area resulting from the presence of nanostructures on sandblasted acid etched (SLA) titanium-zirconium surfaces (TiZr: Roxolid; Institut Straumann AG, Basel, Switzerland) and evaluate the potential effects of surface chemistry and nanotopography on the osseointegration of TiZr disks in a biomechanical implant pull-out model
Atomic force microscopy (AFM) analysis showed that Sdr of the scale-limited surface for dry/nano (Sdrdry/nano; representing the nanotopography of SLActive) was 183 ± 36%, significantly greater than the Sdr for the mod-dry/micro surface (Sdrmod-dry/micro; representing the nanotopography of SLA) of 72 ± 36% (p < 0.001), indicating that the Roxolid dry/nano surface area is 64% greater than that of the Roxolid mod-dry/micro surface due to the presence of nanostructures
Summary
A sandblasted, large-grit, acid-etched surface has become one of the most extensively used surface for dental implants. Greater bone-to-implant contact has been noted in the early healing period with modified SLA implants [12,13] under standard implantation conditions, and in acute buccal dehiscence-type defects [14,15] and in circumferential defects [16,17]. Such results have been confirmed in humans with SLActive implants; a histologic and histometric study demonstrated greater osseointegration compared to SLA implants at 2 and 4 weeks [18]. Several clinical studies have demonstrated high success and survival rates, in a range of clinical situations, including use of short implants [19,20,21], early loading [22], immediate provisionalization [23], in severely resorbed mandibles [24], in the posterior maxilla and mandible [25], in the atrophic maxilla using osteotome sinus floor elevation [26], in irradiated patients [27], on long-term evaluations [28], and in general daily dental practice [29,30,31]
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