Manufacturing Route-Dependent Biointerface Modulation in 3D-Printed and Conventional Dental Implant Systems

Implant manufacturing routes determine surface architecture and, consequently, modulate biointerface interactions that govern early biological responses. Although additive manufacturing has emerged as a promising alternative to conventional subtractive techniques, direct comparisons among commercially available systems remain limited. In this study, a commercially available additively manufactured dental implant was compared with four market-available conventionally machined systems to elucidate manufacturing route-dependent biointerface modulation. Physicochemical properties, surface topography, and electrochemical behavior were evaluated alongside biological responses. Protein adsorption profiles were characterized by liquid chromatography-tandem mass spectrometry (LC-MS/MS), while polymicrobial accumulation was quantified and profiled. Microbially induced surface degradation was assessed by titanium ion release. The additively manufactured implant and the market-leading conventional system exhibited higher surface roughness and distinctive topographical features, which were associated with reduced polymicrobial biofilm accumulation, lower titanium ion release following microbial challenge, and stable electrochemical behavior. Although conventionally machined implants exhibited broader proteomic profiles, functional enrichment analyses revealed overlapping biological categories among implant systems. Collectively, the findings demonstrate that the manufacturing route critically modulates implant biointerface characteristics, with additive manufacturing achieving performance comparable to established commercial systems.