Abstract
Electrochemically anodized (EA) surfaces promise enhanced biological properties and may be a solution to ensure a seal between peri-implant soft tissues and dental transmucosal components. However, the interaction between the modified nano-structured surface and the gingival cells needs further investigation. The aim of this systematic review is to analyze the biological response of gingival cells to EA titanium surfaces in in vitro studies with a score-based reliability assessment. A protocol aimed at answering the following focused question was developed: “How does the surface integrity (e.g., topography and chemistry) of EA titanium influence gingival cell response in in vitro studies?”. A search in three computer databases was performed using keywords. A quality assessment of the studies selected was performed using the SciRAP method. A total of 14 articles were selected from the 216 eligible papers. The mean reporting and the mean methodologic quality SciRAP scores were 87.7 ± 7.7/100 and 77.8 ± 7.8/100, respectively. Within the limitation of this review based on in vitro studies, it can be safely speculated that EA surfaces with optimal chemical and morphological characteristics enhance gingival fibroblast response compared to conventional titanium surfaces. When EA is combined with functionalization, it also positively influences gingival epithelial cell behavior.
Highlights
IntroductionSoft tissue integration is currently a major challenge in implant-prosthetic treatment
Soft tissue integration is currently a major challenge in implant-prosthetic treatment. during the last decade, osteointegration has been the major topic of interest in enhancing the implant survival rate [1], recently, attention has shifted to the barrier formed between the soft tissues and the surface of the transmucosal component
The majority of the studies presented in this review showed that a titanium surface modified by anodization allows, in vitro, better adhesion of human gingival fibroblasts (hGFs) on the surface compared to conventionally polished or machined titanium
Summary
Soft tissue integration is currently a major challenge in implant-prosthetic treatment. During the last decade, osteointegration has been the major topic of interest in enhancing the implant survival rate [1], recently, attention has shifted to the barrier formed between the soft tissues and the surface of the transmucosal component. Further techniques have been proposed to promote the surface bioactivity of Ti surfaces, such as mechanical modifications (sandblasting, acid-etching, micro-grooving), physical modification (laser), chemical modifications, and biological coating (proteins, collagen, hydroxyapatite, nanoparticles). Among these modifications, nano-engineered surfaces have gained interest by mimicking the extracellular matrix substrates.
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