A role for surface topography in creating and maintaining bone at titanium endosseous implants

Area of Science:

• Biomaterials Science
• Dental Implantology
• Orthopedic Research

Background:

• Claims regarding surface topography's effect on osseointegration often lack robust experimental support.
• In vitro and in vivo studies present limitations in interpreting implant osseointegration data.
• The definition and reporting of implant surface topography vary significantly across studies.

Purpose of the Study:

• To review the effects of commercially pure (cp) titanium implant surface topography on osseointegration.
• To identify areas of scientific consensus and highlight existing controversies.
• To evaluate the impact of surface topography on implant-interface biomechanics.

Main Methods:

• Comprehensive literature review of MEDLINE-indexed publications.
• Analysis of research findings from biomedical journals and textbooks.
• Evaluation of in vitro and in vivo experimental data.

Main Results:

• Increased surface topography positively influences osteogenic cellular activity in some in vitro models.
• Animal studies show modest improvements in bone-to-implant contact and biomechanical interlocking with increased surface topography.
• Current data do not identify increased surface topography as a risk factor for peri-implant inflammation.

Conclusions:

• Enhanced cp titanium implant surface topography demonstrably improves bone-to-implant contact and interfacial mechanical properties.
• Clinical evidence supports enhanced bone-to-implant contact with altered cp titanium implants, corroborating preclinical findings.
• The collective experimental evidence supports the use of cp titanium implants with increased surface topography, pending controlled clinical trials.