The impact of different dental implant surface properties to osseointegration success of dental implants – A systematic review

Abstract

Background Osseointegration of dental implants can be considered as the main factor for successful implant stability. This healing process can be related with the surface of dental implants because the surface properties of dental implants affect bone apposition and cell responses. Dental implants have hybrid nature consisting of- implant body which is intrabony part, implant neck which contact with soft tissue and the last part interact with oral environment. So, dental implants have several interfaces and there is a challenge between bacterial colonization and cell functional integration of the dental implant surfaces.. Various surface modifying methods such as blasting, etching, anodizing or coating with biomaterials are introduced. Surface modifications of dental implants is one of the most widely researched fields of implant dentistry. These surface modifications improve the adsorption of protein, cells and so result in faster osseointegration. However, no reports have demonstrated the superiority of one surface treatment over the other. Aim/Hypothesis The purpose of this systematic review was to evaluate the clinical success of different implant surface properties and acquire actual results. Material and Methods An electronic search was conducted in MEDLINE (PubMed search form). The study is based on the Cochrane Review Methods. The main question is ëWhich implant surface modification technique is best in terms of clinical outcomes?’ In last decades (from January 2008 to December 2018), published clinical studies on implants with different surface properties were independently evaluated two reviewers (K.D. and M.H.A.) based on the inclusion criteria. In vitro studies, animal studies, retrospective studies, non-comparative studies and case reports were excluded. (1) Comparative clinical studies of different implant surfaces reporting one year or longer follow-up period, (2) more than ten patients including studies and (3) articles to consider mean marginal bone loss result were included. Results A total of 2604 articles were evaluated from database. 110 articles is repeated, 2,357 articles are animal studies and cell studies, 137 articles not relevant outcomes, 21 clinical studies were evaluated. Three studies excluded because follow-up smaller than 1 year. Remaining 18 studies met the inclusion criteria and included to the review. The modification methods were classified as physically, chemically or biochemically treated. Generally implant failure was related with smoking habit. Because of the low number of studies assessing each surface modification for failure, annual failure rates were not measured by surface modification technique. Implant success were favorable for all modification techniques, but chemically and biochemically modification procedures can improve osseointegration at initial stage. Conclusion and Clinical Implications Within the limitation of this systematic review, it can be concluded that biochemical and chemical techniques can accelerate osseointegration process and may be preferred for early loading planning. However, the studies have different methods and it is difficult to figure out scientifically that superiority of one surface modification technique over another. Further comparative and long term clinical studies are required to identify exact results about the surface modification techniques.