Surface modification of titanium implants with Mg-containing coatings to promote osseointegration.

Abstract

Titanium (Ti) and Ti alloys are commonly used in dental implants, which have good biocompatibility, mechanical strength, processability, and corrosion resistance. However, the surface inertia of Ti implants leads to delayed integration of Ti and new bone, as well as problems such as aseptic loosening and inadequate osseointegration. Magnesium ions (Mg) can promote bone regeneration, and many studies have used Mg-containing materials to modify the Ti implant surface. This systematic review summarizes the methods, effects, and clinical applications of surface modification of Ti implants with Mg-containing coatings. Database collection was completed on Janury 1, 2023, and a total of 29 relevant studies were ultimately included. Mg can be compounded with different materials and coated to the surface of Ti implants using different methods. On the one hand, the surface roughness of implants increases with the addition of Mg-containing coatings, which is thought to have an impact on the osseointegration of the implant. On the other hand, Mg ions promote cell attachment through binding interactions between the integrin family and FAK-related signaling pathways. And Mg ions could induce osseointegration by activating PI3K, Notch, ERK/c-Fos, BMP-4-related signaling pathways and TRPM7 protein channels. In vitro and in vivo experiments have shown that Mg-containing coatings promote cell adhesion and osteogenic differentiation. In addition, Mg-containing implants have been used in clinical trials to assess various outcomes, and the results have shown that there is no synergistic effect between blasting and Mg incorporation, which may be due to the short observation periods. STATEMENT OF SIGNIFICANCE: : As a commonly used dental implant material, the surface inertia of titanium (Ti) implants leads to delayed osseointegration, which may result in aseptic loosening or insufficient osseointegration. Magnesium ions (Mg), known for promoting bone regeneration, have been extensively studied to modify the surface of Ti implants. This paper provides a systematic review of the literature on the surface modification of Ti implants with Mg-containing compounds, highlighting the effects of Mg-containing coatings on the surface properties of Ti implants and associated mechanisms. Furthermore, this study presents the clinical prospects of Mg-modified implants and discusses the challenges that need to be addressed for successful application.