Surface treatments of titanium dental implants for rapid osseointegration

doi:10.1016/j.dental.2006.06.025

Dental Materials

Volume 23, Issue 7, July 2007, Pages 844-854

https://doi.org/10.1016/j.dental.2006.06.025 Get rights and content

Abstract

The osseointegration rate of titanium dental implants is related to their composition and surface roughness. Rough-surfaced implants favor both bone anchoring and biomechanical stability. Osteoconductive calcium phosphate coatings promote bone healing and apposition, leading to the rapid biological fixation of implants. The different methods used for increasing surface roughness or applying osteoconductive coatings to titanium dental implants are reviewed. Surface treatments, such as titanium plasma-spraying, grit-blasting, acid-etching, anodization or calcium phosphate coatings, and their corresponding surface morphologies and properties are described. Most of these surfaces are commercially available and have proven clinical efficacy (>95% over 5 years). The precise role of surface chemistry and topography on the early events in dental implant osseointegration remain poorly understood. In addition, comparative clinical studies with different implant surfaces are rarely performed. The future of dental implantology should aim to develop surfaces with controlled and standardized topography or chemistry. This approach will be the only way to understand the interactions between proteins, cells and tissues, and implant surfaces. The local release of bone stimulating or resorptive drugs in the peri-implant region may also respond to difficult clinical situations with poor bone quality and quantity. These therapeutic strategies should ultimately enhance the osseointegration process of dental implants for their immediate loading and long-term success.

Introduction

In the past 20 years, the number of dental implant procedures has increased steadily worldwide, reaching about one million dental implantations per year. The clinical success of oral implants is related to their early osseointegration. Geometry and surface topography are crucial for the short- and long-term success of dental implants. These parameters are associated with delicate surgical techniques, a prerequisite for a successful early clinical outcome [1]. After implantation, titanium implants interact with biological fluids and tissues. Direct bone apposition onto the surface of the titanium is critical for the rapid loading of dental implants. After the initial stages of osseointegration, both prosthetic biomechanical factors and patient hygiene are crucial for the long-term success of the implants. There are two types of response after implantation. The first type involves the formation of a fibrous soft tissue capsule around the implant. This fibrous tissue capsule does not ensure proper biomechanical fixation and leads to clinical failure of the dental implant. The second type of bone response is related to direct bone–implant contact without an intervening connective tissue layer. This is what is known as osseointegration. This biological fixation is considered to be a prerequisite for implant-supported prostheses and their long-term success. The rate and quality of osseointegration in titanium implants are related to their surface properties. Surface composition, hydrophilicity and roughness are parameters that may play a role in implant–tissue interaction and osseointegration.

This review focuses on the different surfaces and methods that aim to accelerate the osseointegration of dental implants. The physical and chemical properties of implant surfaces are discussed in relation to their biological and clinical behavior. Manufacturers of dental implants have developed a variety of surfaces with different compositions and degrees of roughness. However, there is controversy as to the optimal features for implant surfaces regarding osseointegration kinetics.

Section snippets

Chemical composition of the surface of dental implants

The chemical composition or charges on the surface of titanium implants differ, depending on their bulk composition and surface treatments. The composition and charges are critical for protein adsorption and cell attachment. Dental implants are usually made from commercially pure titanium or titanium alloys. Commercially pure titanium (cpTi) has various degrees of purity (graded from 1 to 4). This purity is characterized by oxygen, carbon and iron content. Most dental implants are made from

Surface roughness of dental implants

There are numerous reports that demonstrate that the surface roughness of titanium implants affects the rate of osseointegration and biomechanical fixation [9], [10]. Surface roughness can be divided into three levels depending on the scale of the features: macro-, micro- and nano-sized topologies.

The macro level is defined for topographical features as being in the range of millimetres to tens of microns. This scale is directly related to implant geometry, with threaded screw and macroporous

Osteoconductive calcium phosphate coatings on dental implants

Metal implants have been coated with layers of calcium phosphates mainly composed of hydroxyapatite. Following implantation, the release of calcium phosphate into the peri-implant region increases the saturation of body fluids and precipitates a biological apatite onto the surface of the implant [65], [66]. This layer of biological apatite might contain endogenous proteins and serve as a matrix for osteogenic cell attachment and growth [67]. The bone healing process around the implant is

Future trends in dental implant surfaces

A few strategies should be considered in order to improve both the short and long-term osseointegration of titanium dental implants. These future trends concern the modifications of surface roughness at the nanoscale level for promoting protein adsorption and cell adhesion, biomimetic calcium phosphate coatings for enhancing osteoconduction and the incorporation of biological drugs for accelerating the bone healing process in the peri-implant area.

Conclusion

There are a number of surfaces commercially available for dental implants. Most of these surfaces have proven clinical efficacy (>95% over 5 years). However, the development of these surfaces 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

Acknowledgements

The authors acknowledge Straumann AG (Bern, Switzerland) for providing the SLA samples, Astra Tech (Astra Zeneca, Rueil-Malmaison, France) for providing the TiOblast™ and OsseoSpeed™ samples. Cam Implants BV (Leiden, The Netherlands) is also acknowledged for providing the TPS and HA plasma-sprayed samples. We also thank Paul Pilet from the Miscoscopy Centre for SEM pictures and Kirsty Snaith for grammar corrections of the manuscript.

References (108)

G. Giavaresi et al.
Mechanical and histomorphometric evaluations of titanium implants with different surface treatments inserted in sheep cortical bone
Biomaterials
(2003)
S. Hansson et al.
The relation between surface roughness and interfacial shear strength for bone-anchored implants. A mathematical model
J Biomech
(1999)
P.M. Brett et al.
Roughness response genes in osteoblasts
Bone
(2004)
M. Browne et al.
Effect of mechanical surface pretreatment on metal ions release
Biomaterials
(2000)
D. Martini et al.
Detachment of titanium and fluorohydroxyapatite particles in unloaded endosseous implants
Biomaterials
(2003)
J.L. Ong et al.
Evaluation of titanium plasma-sprayed and plasma-sprayed hydroxyapatite implants in vivo
Biomaterials
(2004)
C. Aparicio et al.
Corrosion behavior of commercially pure titanium shot blasted with different materials and size of shot particles for dental implant applications
Biomaterials
(2003)
A. Abron et al.
Evaluation of a predictive model for implant surface topography effects on early osseointegration in the rat tibia model
J Prosth Dent
(2001)
O. Zinger et al.
Time-dependent morphology and adhesion of osteoblastic cells on titanium model surfaces featuring scale-resolved topography
Biomaterials
(2004)
S.A. Cho et al.
The removal torque of titanium screw inserted in rabbit tibia treated by dual acid etching
Biomaterials
(2003)

L.F. Cooper et al.

Fluoride modification effects on osteoblast behavior and bone formation at TiO(2) grit-blasted c.p. titanium endosseous implants

Biomaterials

(2006)

K. Yokoyama et al.

Fracture mechanisms of retrieved titanium screw thread in dental implants

Biomaterials

(2002)

Y.T. Sul et al.

Qualitative and quantitative observations of bone tissue reactions to anodised implants

Biomaterials

(2002)

J. Lee et al.

Survival of hydroxypatite-coated implants: a meta-analytic review

J Oral Maxillofac Surg

(2000)

M. Bigerelle et al.

Improvement in the morphology of Ti-based surfaces: a new process to increase in vitro human osteoblast response

Biomaterials

(2002)

X. Wang et al.

Apatite deposition on thermally and anodically oxidized titanium surfaces in a simulated body fluid

Biomaterials

(2003)

B. Yang et al.

Preparation of bioactive titanium metal via anodic oxidation treatment

Biomaterials

(2004)

F. Barrere et al.

Nano-scale study of the nucleation and growth of calcium phosphate coating on titanium implants

Biomaterials

(2004)

P. Habibovic et al.

Biological performance of uncoated and octacalcium phosphate-coated Ti6Al4V

Biomaterials

(2005)

Y. Liu et al.

BMP-2 liberated from biomimetic implant coatings induces and sustains direct ossification in an ectopic rat model

Bone

(2005)

T. Albrektsson et al.

Osseointegrated titanium implants. Requirements for ensuring a long-lasting, direct bone-to-implant anchorage in man

Acta Orthop Scand

(1981)

S. Steinemann

Titanium-the material of choice?

Periodontology 2000

(1998)

D. Buser et al.

Enhanced bone apposition to a chemically modified SLA titanium surface

J Dent Res

(2004)

G. Zhao et al.

High surface energy enhances cell response to titanium substrate microstructure

J Biomed Mater Res A

(2005)

A. Bagno et al.

Surface treatments and roughness properties of Ti-based biomaterials

J Mater Sci Mater Med

(2004)

L. Carlsson et al.

Bone response to plasma-cleaned titanium implants

Int J Oral Maxillofac Implants

(1989)

A. Wennerberg et al.

Glow discharge pre-treated implants combined with temporary bone ischaemia

Swed Dent J

(1991)

D.L. Cochran et al.

Bone response to unloaded and loaded titanium implants with a sandblasted and acid-etched surface: a histometric study in the canine mandible

J Biomed Mater Res

(1998)

A. Wennerberg et al.

A histomorphometric evaluation of screw-shaped implants each prepared with two surface roughnesses

Clin Oral Implants Res

(1998)

D. Buser et al.

Influence of surface characteristics on bone integration of titanium implants. A histomorphometric study in miniature pigs

J Biomed Mater Res

(1991)

K. Gotfredsen et al.

Anchorage of TiO₂-blasted, HA-coated, and machined implants: an experimental study with rabbits

J Biomed Mater Res

(1995)

A. Wennerberg et al.

Histomorphometric and removal torque study of screw-shaped titanium implants with three different surface topographies

Clin Oral Implant Res

(1996)

W. Becker et al.

A prospective multicenter clinical trial comparing one- and two-stage titanium screw-shaped fixtures with one-stage plasma-sprayed solid-screw fixtures

Clin Implant Dent Relat Res

(2000)

T. Albrektsson et al.

The impact of oral implants—past and future, 1966–2042

J Can Dent Assoc

(2005)

T. Testori et al.

A prospective multicenter clinical study of the Osseotite implant: four-year interim report

Int J Oral Maxillofac Implants

(2001)

K. Conner et al.

Guided bone regeneration around titanium plasma-sprayed, acid-etched and hydroxyapatite-coated implants in the canine model

J Periodontol

(2003)

M. Esposito et al.

Interventions for replacing missing teeth: different types of dental implants

Cochrane Database Syst Rev

(2005)

R.M. Urban et al.

Dissemination of wear particles to the liver, spleen and abdominal lymph nodes of patients with hip or knee replacement

J Bone Jt Surg Am

(2000)

M. Roccuzzo et al.

Early loading of sandblasted and acid-etched (SLA) implants: a prospective split-mouth comparative study

Clin Oral Implants Res

(2001)

M. Taba Junior et al.

Radiographic evaluation of dental implants with different surface treatments: an experimental study in dogs

Implant Dent

(2003)

C.J. Ivanoff et al.

Histologic evaluation of the bone integration of TiO(2) blasted and turned titanium microimplants in humans

Clin Oral Implants Res

(2001)

L. Rasmusson et al.

Effects of implant design and surface on bone regeneration and implant stability: an experimental study in the dog mandible

Clin Implant Dent Relat Res

(2001)

K. Gotfredsen et al.

A prospective 5-year study of fixed partial prostheses supported by implants with machined and TiO₂-blasted surface

J Prosthodont

(2001)

L. Rasmusson et al.

A 10-year follow-up study of titanium dioxide-blasted implants

Clin Implant Dent Relat Res

(2005)

D. van Steenberghe et al.

A prospective split-mouth comparative study of two screw-shaped self-tapping pure titanium implant systems

Clin Oral Implants Res

(2000)

P. Astrand et al.

Astra Tech and Branemark System implants: a prospective 5-year comparative study. Results after one year

Clin Implant Dent Relat Res

(1999)

A. Novaes et al.

Histomorphometric analysis of the bone-implant contact obtained with 4 different implant surface treatments placed side by side in the dog mandible

Int J Oral Maxillofac Implants

(2002)

M. Piatelli et al.

Bone response to machined and resorbable blast material titanium implants: an experimental study in rabbits

J Oral Implantol

(2002)

W.D. Mueller et al.

Evaluation of the interface between bone and titanium surfaces being blasted by aluminium oxide or bioceramic particles

Clin Oral Implants Res

(2003)

C. Massaro et al.

Comparative investigation of the surface of commercial titanium dental implants. Part 1: chemical composition

J Mater Sci Mater Med

(2002)

Cited by (1995)

Scratch resistance and in-vitro biocompatibility of plasma-sprayed baghdadite coatings reinforced with carbon nanotubes
2024, Surface and Coatings Technology
Hydroxyapatite (HA, Ca₁₀(PO₄)₆(OH)₂) coatings, commonly used for metallic implants, have limitations such as excessive brittleness, low fracture toughness, inadequate wear resistance, and slow osseointegration properties. In contrast, baghdadite (BAG, Ca₃ZrSi₂O₉), a calcium zirconium silicate-based bioceramic, exhibits outstanding biological properties, to promote cell proliferation and differentiation of human osteoblasts along with adequate mechanical strength. In this study, plasma-sprayed HA, BAG, and carbon nanotubes (CNT, 1 wt%, and 2 wt%) reinforced BAG coatings are deposited on titanium (Ti) substrate to enhance its mechanical as well as biological properties. The microhardness values of CNT-reinforced BAG coatings increase due to a decrease in porosity and the retention of CNT inside the BAG matrix. Progressive loading scratch tests are performed, revealing a reduction in wear volume loss from 15.051 mm³ to 12.574 mm³ and scratch rate from 43.262 mm³N⁻¹ m⁻¹ to 36.172 mm³N⁻¹ m⁻¹ with the addition of 2 wt% CNT in BAG coatings. The scratch hardness test results demonstrated that introducing CNT into BAG coating significantly enhances its performance, showing a remarkable 38.7 % improvement. In-vitro cell culture studies indicate excellent cell adhesion, growth, and proliferation of MC3T3-E1 osteoblast cells on the surfaces of the CNT-reinforced BAG coatings.
Osseointegrative and immunomodulative 3D-Printing Ti6Al4V-based implants embedded with biogenic hydroxyapatite
2024, Materials and Design
Although titanium-based metal implants have become a game changer in dental and orthopedic therapies, they still have several problems such as late osseointegration and immune response. In this study, we present a novel strategy to develop Ti6Al4V-based implants embedded with biogenic hydroxyapatite derived from equine bone to overcome these problems. A selective laser melting technique was employed for facile fabrication with flexible fusing feedstock and regular uniform distribution of equine bone. The physicochemical characteristics, cell attachment and proliferation, osteogenic differentiation, osseointegration, inflammatory response, and metabolomics of the developed Ti6Al4V/equine bone composite were then investigated. The Ti6Al4V-based composite integrated with equine bone at a certain concentration has improved the crystalline structure (β-Ti) suitable for implantation and exhibited higher hydrophilicity and protein adsorption. They significantly promoted cell attachment, osteogenic differentiation, and anti-inflammatory effects in vitro. In vivo study confirmed the osseointegration and alleviated inflammatory responses. Furthermore, the Ti6Al4V-based implants integrated with equine bone significantly reduced metabolites associated with inflammatory responses both in vitro and in vivo. The observed reduction in inflammatory responses suggests a subsequent promotion of osteogenesis. These promising results position the Ti6Al4V-based implant integrated with equine bone as a potential candidate for replacing conventional dental and orthopedic implants.
Comparative analysis of the physical, chemical, and microbiological properties of Ti-6Al-4V disks produced by different methods and subjected to surface treatments
2024, Journal of Prosthetic Dentistry
To improve the osseointegration of dental implants and reduce microbiological growth, different micro- and nanoscale surface topographies can be used.
The purpose of this in vitro study was to evaluate the influence of Ti-6Al-4V with 4 surfaces, machined (DU), machined+hydroxyapatite (DUHAp), machined+acid-alkali treatment (DUAA), and additive manufacturing (DMA), on the physical, chemical, and microbiological properties.
The topography of Ti-6Al-4V disks with the 4 surfaces was evaluated by scanning electron microscopy (SEM), the chemical composition by energy dispersive X-ray spectroscopy (EDS), and the crystalline structure by X-ray diffraction (XRD). Physical and chemical properties were analyzed by using wettability and surface free energy, roughness, and microbial adhesion against Staphylococcus aureus by colony forming units (CFU). One-way ANOVA analysis of variance and the Tukey multiple comparisons test were applied to evaluate the data, except CFU, which was submitted to the Kruskal-Wallis nonparametric test (α=.05).
DU photomicrographs showed a topography characteristic of a polished machined surface, DUHAp and DUAA exhibited patterns corresponding to the surface modifications performed, and in DMA the presence of partially fused spherical particles was observed. The EDS identified chemical elements inherent in the Ti-6Al-4V, and the DUHAp and DUAA disks also had the ions from the treatments applied. XRD patterns revealed similarities between DU and DMA, as well as characteristic peaks of hydroxyapatite (HA) in the DUHAp disk and the DUAA. Compared with DU and DMA the DUHAp and DUAA groups showed hydrophilic behavior with smaller contact angles and higher surface free energy (P<.05). DMA showed a higher mean value of roughness, different from the others (P<.05), and a higher CFU for S. aureus (P=.006).
DUHAp and DUAA showed similar behaviors regarding wettability, surface free energy, and bacterial adhesion. Among the untreated groups, DMA exhibited higher roughness, bacterial adhesion, and lower wettability and surface free energy.
Effect of adding selected carboxylic acids to the solution on electrophoretic deposition, adhesion strength, morphology and antibacterial properties of chitosan coatings on titanium
2024, Progress in Organic Coatings
In the presented work, the possibility of developing chitosan (CS) coatings on Ti substrates by electrophoretic deposition (EPD) from different acidic solutions was studied. The effect of various acids from the carboxylic acid group used in the EPD solutions on the structure and properties of chitosan coatings was investigated. Two acids were chosen that had already been used to prepare EPD chitosan solutions: acetic acid (HOAc) and citric acid (CiA). In addition, malic acid (MaA) was investigated as a novel potential biodegradable natural ingredient. Homogeneous coatings with high adhesion strength were obtained, regardless of the acid used. The coatings showed a roughness higher than that of the uncoated Ti substrate. It was found that acids from the alpha-hydroxy acids group (AHAs, CiA and MaA) not only protonate the amino groups of chitosan but also change its structure, through the proposed cross-linking mechanism. This was reflected in the surface wettability of the coatings. For coatings obtained from the solution with HOAc, the contact angle was about 80° and for those developed from solutions with MaA and CiA, it was about 50°. Microbiological studies revealed that the coatings deposited from solutions containing HOAc and CiA had the highest bactericidal activity.
Research hotspots and trends of nanomaterials in stomatology: A bibliometric analysis from 2000 to 2023
2024, Heliyon
Nanomaterials (NMs) have emerged as highly promising candidates for stomatology due to their excellent quality and remarkable progress in recent years. However, with the rapid expansion of the research scale, challenges arise in the technological decision-making and research management processes, and therefore difficulty for researchers to understand the knowledge structure and research hotspots has increased significantly. This study aims to make a comprehensive summary of authors, institutions, journals, research topics, development trends, and research hotspots of NMs in stomatology through bibliometric analysis for the sake of providing references for scientific decision-making, research management, and academic exploration in this filed.
Studies on research and application of NMs in stomatology were retrieved from the Web of Science Core Collection (WoSCC) from January 1, 2000 to April 27, 2023. Bibliometric analysis and visualization were conducted using CiteSpace and VOSviewer.
A total of 620 articles were included in this study, showing a gradual increase in the number of publications focusing on NMs in stomatology. Globally, China ranked first with 130 publications, and the United States (US) enjoyed the highest citation count (n = 5218) and average citation per paper (ACP) (n = 52.18). The top three institutions with the highest publication output were the University of Sao Paulo (n = 22), the Chinese Academy of Sciences (n = 20), and Shanghai Jiaotong University (n = 13). The journals MATERIALS and NANOMATERIALS emerged as the most popular in this field (n = 20), and BIOMATERIALS had the highest co-citations (n = 1597). The most prolific author was Dos Reis and Andrea Candido (n = 7), while Thomas J. Webster enjoyed the highest co-citations (n = 94). Burstness analysis of the references revealed a prominent research focus on nanoparticle drug delivery systems (specifically lipid nanoparticles). Keyword burstness analysis identified "oxide nanoparticle" as the primary frontier keyword in this field.
This is the first study of using bibliometric analysis to summarize the research trends and frontiers of NMs in stomatology. With progressive advancements in the research and application of NMs in oral healthcare, their academic impact is steadily increasing. China and the US maintain a leading position in this field. Future directions could primarily focus on the development and application of nanoparticle drug delivery systems (especially lipid nanoparticles) and metal oxide nanoparticles (especially in antibacterial aspects). We hope that this bibliometric analysis could provide researchers with a panoramic view and useful references for future research, thus promoting the development of NMs in stomatology.
Corrosion behaviour of plasma-sprayed baghdadite bioceramic coatings reinforced with carbon nanotubes
2024, Journal of Alloys and Compounds
Bioceramics have been extensively used for the restoration and replacement of hard tissues, such as bones and teeth due to their physicochemical resemblance to these tissues. This study focuses on enhancing the properties of plasma-sprayed bioceramic coatings with the addition of carbon nanotubes. The coatings deposited include hydroxyapatite, baghdadite, and baghdadite with carbon nanotube reinforcement. The effect of incorporating carbon nanotubes into baghdadite coatings is thoroughly investigated in terms of microstructural, mechanical, and electrochemical properties. Multiple characterization techniques such as scanning electron microscopy, energy dispersive spectroscopy, X-ray diffractometry, and Raman spectroscopy have been employed to reveal microstructural details, elemental composition, and phase constituents of the deposited coatings. The results indicate that baghdadite coatings exhibit higher porosity compared to hydroxyapatite coatings. However, the addition of carbon nanotubes as reinforcement into baghdadite coatings effectively reduces porosity by integrating carbon nanotubes within the inter-lamellae structure and filling voids within the inter-splat regions. This integration also mitigates common post plasma spray defects including porosity, voids, and microcracks. The incorporation of 2 wt% carbon nanotubes into the baghdadite matrix results in a substantial 80% reduction in corrosion current density(Icorr). This reduction is attributed to the combined effects of reduced porosity, and improved structural integrity due to carbon nanotubes. Furthermore, the carbon nanotubes reinforced baghdadite coatings have indicated the healthy development of the MC3T3-E1 osteoblast cell line.

View all citing articles on Scopus

View full text

ReviewSurface treatments of titanium dental implants for rapid osseointegration

Abstract

Introduction

Section snippets

Chemical composition of the surface of dental implants

Surface roughness of dental implants

Osteoconductive calcium phosphate coatings on dental implants

Future trends in dental implant surfaces

Conclusion

Acknowledgements

Biomaterials

J Biomech

Bone

Biomaterials

Biomaterials

Biomaterials

Biomaterials

J Prosth Dent

Biomaterials

Biomaterials

Biomaterials

Biomaterials

Biomaterials

J Oral Maxillofac Surg

Biomaterials

Biomaterials

Biomaterials

Biomaterials

Biomaterials

Bone

Osseointegrated titanium implants. Requirements for ensuring a long-lasting, direct bone-to-implant anchorage in man

Acta Orthop Scand

Titanium-the material of choice?

Periodontology 2000

Enhanced bone apposition to a chemically modified SLA titanium surface

J Dent Res

High surface energy enhances cell response to titanium substrate microstructure

J Biomed Mater Res A

Surface treatments and roughness properties of Ti-based biomaterials

J Mater Sci Mater Med

Bone response to plasma-cleaned titanium implants

Int J Oral Maxillofac Implants

Glow discharge pre-treated implants combined with temporary bone ischaemia

Swed Dent J

Bone response to unloaded and loaded titanium implants with a sandblasted and acid-etched surface: a histometric study in the canine mandible

J Biomed Mater Res

A histomorphometric evaluation of screw-shaped implants each prepared with two surface roughnesses

Clin Oral Implants Res

Influence of surface characteristics on bone integration of titanium implants. A histomorphometric study in miniature pigs

J Biomed Mater Res

Anchorage of TiO2-blasted, HA-coated, and machined implants: an experimental study with rabbits

J Biomed Mater Res

Histomorphometric and removal torque study of screw-shaped titanium implants with three different surface topographies

Clin Oral Implant Res

A prospective multicenter clinical trial comparing one- and two-stage titanium screw-shaped fixtures with one-stage plasma-sprayed solid-screw fixtures

Clin Implant Dent Relat Res

The impact of oral implants—past and future, 1966–2042

J Can Dent Assoc

A prospective multicenter clinical study of the Osseotite implant: four-year interim report

Int J Oral Maxillofac Implants

Guided bone regeneration around titanium plasma-sprayed, acid-etched and hydroxyapatite-coated implants in the canine model

J Periodontol

Interventions for replacing missing teeth: different types of dental implants

Cochrane Database Syst Rev

Dissemination of wear particles to the liver, spleen and abdominal lymph nodes of patients with hip or knee replacement

J Bone Jt Surg Am

Early loading of sandblasted and acid-etched (SLA) implants: a prospective split-mouth comparative study

Clin Oral Implants Res

Radiographic evaluation of dental implants with different surface treatments: an experimental study in dogs

Implant Dent

Histologic evaluation of the bone integration of TiO(2) blasted and turned titanium microimplants in humans

Clin Oral Implants Res

Effects of implant design and surface on bone regeneration and implant stability: an experimental study in the dog mandible

Clin Implant Dent Relat Res

A prospective 5-year study of fixed partial prostheses supported by implants with machined and TiO2-blasted surface

J Prosthodont

A 10-year follow-up study of titanium dioxide-blasted implants

Clin Implant Dent Relat Res

A prospective split-mouth comparative study of two screw-shaped self-tapping pure titanium implant systems

Clin Oral Implants Res

Review
Surface treatments of titanium dental implants for rapid osseointegration

Anchorage of TiO₂-blasted, HA-coated, and machined implants: an experimental study with rabbits

A prospective 5-year study of fixed partial prostheses supported by implants with machined and TiO₂-blasted surface