Dental implant surface treatment - Key methods and considerations i-Fix

 

Dental implants are currently one of the most advanced treatment options for people who are partially or completely edentulous. In recent decades, dental implants have enhanced the quality of life for millions of patients and demonstrated excellent success predictability. One of the most difficult tasks has been determining which dental implant design exhibits the optimum biomechanical behaviour in each clinical circumstance. Among the various factors that governed these behaviours, the key most is the dental implant surface. Since its inception, Titanium has been the key component of dental implants. Therefore, Titanium dental implants surface treatment with various techniques is crucial for its long-term success. In this blog, you will learn about the various aspects of dental implant surface treatments and their implications.

What role does dental implant surface play?

Numerous studies have shown that the surface roughness of titanium dental implants impacts osseointegration rates. Also, the composition of titanium dental implants affects their and biomechanical fixation rate. Implants with a rough surface promote both bone anchoring and biomechanical stability. The dental implant by Branemark had a relatively smooth surface with an average roughness of about 0.5–1.0micro meter. However, it has been established that rough-surfaced titanium dental implants have a higher proportion of bone-to-implant contact rate than smooth-surfaced titanium dental implants. Moreover, the hydrophilicity of titanium implants is also influenced by the surface chemical composition. In terms of interactions with biological fluids, cells, and tissues, highly hydrophilic surfaces appear to be preferable over hydrophobic ones.

The healing time for osseointegration and, ultimately, the outcome of implant treatment is both influenced by the surface. It is the only area of the implant that is exposed to the oral environment. Therefore, its chemical, physical, mechanical, and topographic surface qualities are all critical for osseointegration success.

How dental implants surface treatment has evolved?

 

As dentistry evolved with time, so does  dental implants. Today, titanium dental implant surfaces come in a variety of shapes and sizes. The Brnemark's first implants, which he developed over 50 years ago, had a smooth, polished surface. It required three to six months of healing before they could be loaded successfully.

Since then, the design and architecture of titanium dental implants and their surface topography have changed and evolved. This has increased the osseointegration and long-term implant survival rates.

Implant surfaces can be adjusted in three different ways during the manufacturing process. Though the treatment methods differ, the goal is the same. Produce a strong biological and mechanical attachment to the alveolar bone in a short amount of time. This, as a result, lowers the chances of implant failure.  A widespread range of implant surfaces has been produced for years. However, their respective analysis for short term and long-term success rates have only lately been evaluated and compared.

 

What are the various methods used for dental implant surface treatment?

The various mechanical, chemical and physical dental implant surface treatment methods are:

·         Grit blasting or sandblasting: This is the process of using compressed air to accelerate an abrasive medium via a blasting nozzle. Surface irregularity will be created as a result of this technique. The surface of titanium implants is roughened by blasting them with hard ceramic particles.

·         Acid etching: This technique is carried out in a bath of HCL, H2SO4, and HNO3 in various combinations. Strong acids such as hydrochloric acid, sulfuric acid, and nitric acid at temperatures above 100°C are used here. They etch the surface and make the dental implant roughened. Micro pits of 0.5-2mm will be created as a result of this operation. The use of a dual acid etching approach was found to be more effective in achieving the required outcomes.

·         Dual acid etching: This approach is used to improve the biological properties of dental implants by enhancing the submicron topography. This is accomplished by soaking the titanium implant in HCL and H2SO4 solution and heating it to temperatures exceeding 100°C. Increased osteoconductive activity is one of the benefits of this method.

·         Acid etching and sand blasting: A mix of sand blasting and acid etching can be used to modify the surface. Blasting with different particles, such as Al2O3 and TiO2, is followed by etching with HCl and H2SO4. This will result in a micro and macro-structure change. It has a stronger potential to trigger cell growth and has more Osseo conductive characteristics.

·         Laser peening: It is a newly developed technology that allows us to do contamination-free peening. The process involved striking a protective layer on the metallic surface with high intensity nanosecond laser pulses (3-5 width). It melts the surface layer locally. Due to the lack of touch in this procedure, there is little likelihood of thermal or mechanical deformation of the substrate.

·         Electropolishing: Electrochemical polishing, anodic polishing, and electrolytic polishing are all terms used to describe this technique. This procedure removes material from a metallic workpiece, removing surface roughness and peaks and valleys in the process. As a result, this process is utilised to polish and passivate metallic surfaces. The electrolyte is usually a strong acid solution with a high viscosity, such as sulphuric acid or phosphoric acid.

·         Plasma spraying: This method involves pouring of molten metal onto a titanium base, resulting in surface irregularities such as valleys and pores. The resulting layer will be uniform, smooth, and hard. In soft bone, the development of bone to this imperfection will generate a mechanical interlock. This further aid in the initial anchoring of the implant.

Titanium plasma spraying involves heating titanium to a plasma state and then pouring the plasma onto the implant surface. This improves micro retention irregularities while also increasing surface area.

·         Hydroxyapatite coating: Hydroxyapatite is a substance that can build a strong and direct bond between the implant and the bone. This is accomplished by heating hydroxyapatite in a plasma flame at a temperature of 1.50K-2.00K. It then forces onto the implant surface in an inert atmosphere. The coating thickness is 50-200 micrometre, and the roughness is 7-24 micrometre. The surface area can be increased by coating with hydroxyapatite. With this covering, the bone-implant contact was found to be better established.

·         Sintering: This dental implant surface treatment technique involves the direct metal laser sintering (DMLS) method. It’s a laser-based AM process that involves layering powdered metals, radiant heaters, and a computer-controlled laser to create an item. DMLS technology can be utilised to create an implant that is compatible with the bone.

·         Anodization: This dental implant surface treatment method uses an electrochemical reaction.  This technique deposits oxide layers on the Ti implant surface. In this procedure, the oxidised titanium surface acts as an anode in an electrochemical cell. The diluted acid solution functions as the electrolyte. Anodized surfaces result in a strong bond between the implant and the bone.

·         Sol-gel coating: On the implant surface, this approach uses a thin, homogeneous chemical dispersion. It has numerous benefits, including increased toughness, early bone growth, and improved osseointegration.

·         Biomimetic precipitation: It’s a dental implant surface treatment procedure in which a biomimetic substance is applied to the implant surface. An "agent/material capable of replicating or imitating a body form and function” is referred to as a biomimetic agent. Such biomimetic coatings have been demonstrated to be more soluble in physiological fluids and resorbable by osteoclastic cells like dentin materials.

·         Electrophoretic deposition: This is the process by which colloidal particles in a liquid media, such as nano precipitates. It is moved under the influence of an electric field and deposit on a counter-charged electrode. The pressure exerted by the potential difference between electrodes is all that is required to form a coating.

Overall, the use of surface treatments in the field of implantology has resulted in a significant rise in implant success rates. The main problem is that this approach is usually performed in conditions that are not natural. As a result, the tissue's reaction to this surface treatment must be properly comprehended. The success of an implant is contingent on the use of numerous adjustments by the situation to maximise the patient's benefit.

 

Kamal Medtech today represents the face of Indian titanium dental implants. The scientific and research division of Kamal Medtech, a dental implant manufacturer in India, has used various dental implant surface treatment methods to produce the best-in-class Indian dental implants. We take pride to produce quality Indian dental implants which are tested on ISO optimum quality standards. If you have any questions related to the surface treatment of dental implants then please contact us or write us.