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How surface coatings on titanium implants affect keratinized tissue: A systematic review.
Casper E Van den Borre1,2, Brandaan G R Zigterman2, Maurice Y Mommaerts2
1Doctoral School of Life Sciences and Medicine, Vrije Universiteit Brussel, Brussels, Belgium.
Summary
Surface coatings can improve soft-tissue integration for percutaneous titanium implants, enhancing stability. Larger pores and nanostructured ceramics show promise, but more long-term studies are needed for optimal implant success.
Area of Science:
- Biomaterials Science
- Tissue Engineering
- Implantology
Background:
- Percutaneous titanium implant survival depends on soft-tissue integration beyond osseointegration.
- A robust connective tissue seal is crucial to prevent implant complications like dehiscence and epithelial downgrowth.
- Implant surface characteristics significantly influence the biological response of surrounding keratinized tissues.
Purpose of the Study:
- To systematically review the in vivo effects of various implant coatings on soft-tissue integration.
- To evaluate how different coating systems influence the interface between titanium implants and keratinized soft tissues.
Main Methods:
- A comprehensive systematic literature search was conducted in March 2021.
- 12 relevant studies were included from 4971 initial publications.
- Coating systems were categorized into metallic, ceramic, and composite subgroups for analysis.
Main Results:
- Several coatings demonstrated improved soft-tissue integration compared to pristine titanium.
- Large-pore titanium coatings (>700 μm) facilitated vascularized soft-tissue infiltration and cell attachment.
- Nanostructured ceramic coatings reduced inflammation and promoted cell adhesive structures (hemidesmosomes); biomolecule coatings, like FGF-2 in apatite, showed potential for natural attachment.
Conclusions:
- Certain coatings, particularly those with larger pores or nanostructured ceramics, enhance soft-tissue integration around titanium implants.
- Biomolecule coatings require durable fixation to be effective in stimulating soft-tissue response.
- Robust, long-term in vivo studies are lacking, necessitating further research to establish optimal coating strategies for percutaneous implants.
