Defining surfaces : Implant topography – a review (Preprint)

BACKGROUND . A variety of claims are made regarding the effects of surface topography on implant osseointegration. The development of implant surfaces topography has been empirical, requiring numerous in vitro and in vivo tests. Most of these tests were not standardized, using different surfaces, cell populations or animal models. The exact role of surface chemistry and topography on the early events of the osseointegration of dental implants remain poorly understood. OBJECTIVE This review considers the major claims made concerning the effects of titanium implant surface topography on osseointegration. The osseointegration rate of titanium dental implants is related to their composition and surface roughness. The different methods used for increasing surface roughness or applying osteoconductive coatings to titanium dental implants are reviewed. Important findings of consensus are highlighted, and existing controversies are revealed. METHODS This review considers many of the research publications listed in MEDLINE and presented in biomedical research publications and textbooks. Surface treatments, such as titanium plasma-spraying, grit-blasting acid-etching,alkaline etching, anodization,polymer demixing ,sol gel conversion and their corresponding surface morphologies and properties are described. RESULTS Many in vitro evaluations are not predictive of or correlated with in vivo outcomes. In some culture models, increased surface topography positively affects pro-osteogenic cellular activities. Many studies reveal increase in bone-to-implant contact,with increased surface topography modifications on implant surfaces. CONCLUSIONS Increased implant surface topography improves the bone-to-implant contact and the mechanical properties of the enhanced interface.