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Soft and Hard Tissue Integration around Percutaneous Bone-Anchored Titanium Prostheses: Toward Achieving Holistic
Sangeeta Shrivas1, Harshita Samaur1, Vinod Yadav1
1Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Khandwa Road, Simrol, Indore 453552, India.
ACS Biomaterials Science & Engineering
|March 26, 2024
Summary
Achieving long-lasting percutaneous implants requires better soft tissue integration. New bioadhesives show promise for improving implant sealing and preventing inflammation, enhancing device longevity.
Area of Science:
- Biomaterials Science
- Tissue Engineering
- Medical Implant Technology
Background:
- Percutaneous bone-anchored prostheses require integration with both hard and soft tissues for longevity.
- Titanium (Ti) implants achieve good osseointegration but struggle with soft tissue integration, leading to inflammation and poor sealing.
- This contrasts with natural structures like nails and teeth, which exhibit superior soft tissue sealing.
Purpose of the Study:
- To review implant surface treatments and coatings for improved osseointegration, soft tissue integration, and bacterial resistance.
- To explore strategies for enhancing soft tissue attachment to metallic percutaneous implants.
- To propose novel solutions for overcoming the limitations of current implant designs.
Main Methods:
- Review of existing literature on titanium (Ti) surface modifications and coatings.
- Analysis of surface treatments like sandblasting with large grit and acid etching (SLA) and calcium phosphate (CaP) coatings.
- Examination of nanoporous and nanotubular titania structures, microgrooves, and biomolecular coatings.
- Discussion of bioadhesive properties for soft tissue integration.
Main Results:
- Surface microroughness (SLA) and porous calcium phosphate (CaP) coatings enhance osseointegration.
- Smooth and textured titania nanopores, nanotubes, microgrooves, and biomolecular coatings promote soft tissue attachment.
- Despite advancements, inferior peri-implant soft tissue sealing remains a challenge, risking peri-implantitis.
Conclusions:
- Improving soft tissue integration is crucial for the long-term success of percutaneous metallic prostheses.
- Advanced surface modifications and coatings offer potential benefits for both hard and soft tissue integration.
- Smart multifunctional bioadhesives with adhesion, resilience, antibacterial, and immunomodulatory properties are proposed as a promising future direction.
