Effects of implant surface coatings and composition on bone integration: a systematic review

Abstract

Objective: The aim of the present review was to evaluate the bone integration efficacy of recently developed and marketed oral implants as well as experimental surface alterations.

Materials and methods: A PubMed search was performed for animal studies, human reports and studies presenting bone-to-implant contact percentage or data regarding mechanical testing.

Results: For recently developed and marketed oral implants, 29 publications and for experimental surface alterations 51 publications fulfilled the inclusion criteria for this review.

Conclusions: As demonstrated in the available literature dealing with recently developed and marketed oral implants, surface-roughening procedures also affect the surface chemical composition of oral implants. There is sufficient proof that surface roughening induces a safe and predictable implant-to-bone response, but it is not clear whether this effect is due to the surface roughness or to the related change in the surface composition. The review of the experimental surface alterations revealed that thin calcium phosphate (CaP) coating technology can solve the problems associated with thick CaP coatings, while they still improve implant bone integration compared with non-coated titanium implants. Nevertheless, there is a lack of human studies in which the success rate of thin CaP-coated oral implants is compared with just roughened oral implants. No unequivocal evidence is available that suggests a positive effect on the implant bone integration of peptide sequences or growth factors coated on titanium oral implants. In contrast, the available literature suggests that bone morphogenetic protein-2 coatings might even impede the magnitude of implant-to-bone response.