Implant functionalization with mesoporous silica: A promising antibacterial strategy, but does such an implant osseointegrate?

Katleen Vandamme,Bruno P A Cammue,Marcelo F Mesquita,Kaat De Cremer,Wander José Da Silva,Jimoh Agbaje,Jozef Vleugels,Johan A Martens,Annabel Braem,Evelien Gerits,Jan Michiels,Karin Thevissen,Ruxandra‐Gabriella Coropciuc,Patrick Thevissen

doi:10.1002/cre2.389

Abstract

ObjectivesNew strategies for implant surface functionalization in the prevention of peri‐implantitis while not compromising osseointegration are currently explored. The aim of this in vivo study was to assess the osseointegration of a titanium‐silica composite implant, previously shown to enable controlled release of therapeutic concentrations of chlorhexidine, in the Göttingen mini‐pig oral model.Material and MethodsThree implant groups were designed: macroporous titanium implants (Ti‐Porous); macroporous titanium implants infiltrated with mesoporous silica (Ti‐Porous + SiO2); and conventional titanium implants (Ti‐control). Mandibular last premolar and first molar teeth were extracted bilaterally and implants were installed. After 1 month healing, the bone in contact with the implant and the bone regeneration in the peri‐implant gap was evaluated histomorphometrically.ResultsBone‐to‐implant contact and peri‐implant bone volume for Ti‐Porous versus Ti‐Porous + SiO2 implants did not differ significantly, but were significantly higher in the Ti‐Control group compared with Ti‐Porous + SiO2 implants. Functionalization of titanium implants via infiltration of a SiO2 phase into the titanium macropores does not seem to inhibit implant osseointegration. Yet, the importance of the implant macro‐design, in particular the screw thread design in a marginal gap implant surgery set‐up, was emphasized by the outstanding results of the Ti‐Control implant.ConclusionsNext‐generation implants made of macroporous Ti infiltrated with mesoporous SiO2 do not seem to compromise the osseointegration process. Such implant functionalization may be promising for the prevention and treatment of peri‐implantitis given the evidenced potential of mesoporous SiO2 for controlled drug release.

Highlights

Alterations in manufacturing processes and surgical techniques in implant therapy together with decreasing costs have rendered implant therapy for oral rehabilitation in partially and fully edentulous patients common
Developments in implant dentistry were mainly related to enhance the rate of implant osseointegration as well as to address conditions with impaired bone quality at the bone-implant interface (Joos et al, 2006; Nkenke & Fenner, 2006; Rupp et al, 2018)
In order to accelerate the process of osseointegration and improve the strength of the established bone-implant interface, implant surface characteristics have been investigated extensively (Meirelles et al, 2008; Pellegrini et al, 2018; Smeets et al, 2016; Wennerberg & Albrektsson, 2010)

Summary

Introduction

Alterations in manufacturing processes and surgical techniques in implant therapy together with decreasing costs have rendered implant therapy for oral rehabilitation in partially and fully edentulous patients common. High success levels (>95%) and good predictability have motivated patients to choose treatment with implants (Buser et al, 2017; Esposito et al, 2014; Naert et al, 2002; Quirynen et al, 2014). In order to accelerate the process of osseointegration and improve the strength of the established bone-implant interface, implant surface characteristics have been investigated extensively (Meirelles et al, 2008; Pellegrini et al, 2018; Smeets et al, 2016; Wennerberg & Albrektsson, 2010). Summarized research findings point out two aspects as main causes of implant failure: occlusal overload and periimplantitis (Naert et al, 2012; Renvert & Quirynen, 2015; Schwarz et al, 2018)

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