The Effects of Titanium Implant Surface Topography on Osseointegration: Literature Review

Background: A variety of claims are made regarding the effects of surface topography on implant osseointegration. The development of implant surfaces topography has been empirical, requiring numerous in vitro and in vivo tests. Most of these tests were not standardized, using different surfaces, cell populations, or animal models. The exact role of surface chemistry and topography on the early events of the osseointegration of dental implants remains poorly understood. Objective: The aim of this study was to consider the major claims made concerning the effects of titanium implant surface topography on osseointegration. The osseointegration rate of titanium dental implants is related to their composition and surface roughness. The different methods used for increasing surface roughness or applying osteoconductive coatings to titanium dental implants were reviewed. Important findings of consensus were highlighted, and existing controversies were revealed. Methods: This paper considered many of the research publications listed in Medical Literature Analysis and Retrieval System Online and presented in biomedical research publications and textbooks. Surface treatments, such as titanium plasma spraying, grit blasting, acid etching, alkaline etching, anodization, polymer demixing, sol-gel conversion, and their corresponding surface morphologies and properties were described. Results: Many in vitro evaluations are not predictive of or correlated with in vivo outcomes. In some culture models, increased surface topography positively affects proosteogenic cellular activities. Many studies reveal increase in bone-to-implant contact (BIC), with increased surface topography modifications on implant surfaces. Conclusions: Increased implant surface topography improves the BIC and the mechanical properties of the enhanced interface. (JMIR Biomed Eng 2019;4(1):e13237) doi: 10.2196/13237