Titanium surface modifications and their soft-tissue interface on nonkeratinized soft tissues-A systematic review...

Area of Science:

• Biomaterials Science
• Tissue Engineering
• Medical Implantology

Background:

• Titanium (Ti) and its alloys are widely used in medical implants due to their biocompatibility.
• The interface between implants and surrounding soft tissues is crucial for successful integration and function.
• Understanding how surface characteristics influence this interface is key to improving implant outcomes.

Purpose of the Study:

• To systematically review the literature on the surface aspects of titanium implants and their interaction with nonkeratinized soft tissues.
• To identify how different surface modifications affect the implant-soft tissue interface, particularly regarding liquid space formation and tissue adhesion.

Main Methods:

• A comprehensive systematic literature search was conducted in July 2019.
• Included studies were restricted to in vivo animal models, with 19 publications selected from 651 initial results.
• Studies were categorized into five subgroups based on surface modification types: mechanical, oxidative, sol-gel TiO2 coatings, biofunctionalized, and other.

Main Results:

• Surface roughness between Ra = 0.5 and 1.0 μm for machined Ti implants promoted soft tissue adhesion.
• Smoother surfaces (except for acid polished and anodized Ti at Ra = 0.2 μm) generally prevented soft tissue adhesion.
• A fibroblast growth factor 2 apatite composite coating enhanced soft tissue attachment, forming Sharpey-like fibers.

Conclusions:

• Titanium implant surface topography significantly impacts soft tissue integration.
• Specific surface modifications, such as controlled roughness and biofunctional coatings, can promote desirable tissue adhesion.
• Optimizing the implant-soft tissue interface holds potential for achieving near-perfect integration.