Success and survival of titanium surface modification on dental implant osseointegration: a systematic review

Introduction The quality of the coating on dental titanium (Ti) implants plays a crucial role in osseointegration. Surface treatments are essential because they modulate cellular behaviour at the bone - implant interface, enhancing healing and long-term mechanical stability.Aims To evaluate the clinical longevity of dental Ti implants with different surface treatments, based on success and survival rates.Methods A systematic search of five databases and grey literature was conducted. Both randomised controlled trials and non-randomised interventional studies were included. Risk of bias was assessed using the Cochrane Risk of Bias tool.Results In total, 30 studies involving 1,719 participants were included. Surface treatments were classified as mechanical, chemical, physical, or combined. Follow-up periods ranged from six weeks to 72 months. Success rates were consistently high (90.9-100%), while survival rates varied according to the type of surface modification and follow-up duration. Risk of bias ranged from low to high.Discussion Although surface-treated implants generally demonstrated favourable outcomes, heterogeneity in study design and follow-up periods limited direct comparisons. The observed variability in survival rates underscores the need to refine surface technologies and standardise clinical protocols.Conclusion Additional high-quality studies are needed to determine which surface modifications provide superior longevity and clinical reliability.