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Comparative Study
. 2026 Jan 30:36:e256596.
doi: 10.1590/0103-644020256596. eCollection 2026.

Biological equivalence of additive manufacturing titanium vs conventional implants in peri-implantitis

[Article in Portuguese]
Pedro Henrique de Azambuja Carvalho  1 , Ana Paula Farnezi Bassi  2 , Vinícius Ferreira Bizelli  2 , Julia Ferrazoli de Oliveira  1 , Marisa Aparecida Cabrini Gabrielli  1 , Valfrido Antonio Pereira-Filho  1
Affiliations
Comparative Study

Biological equivalence of additive manufacturing titanium vs conventional implants in peri-implantitis

[Article in Portuguese]
Pedro Henrique de Azambuja Carvalho et al. Braz Dent J. .

Abstract
in English, Portuguese

The global increase in the use of dental implants also increases treatment-related complications. Peri-implantitis is a matter of concern at this stage. This study aimed to compare the behavior of an additive manufacturing implant with commercially available implants with different surface treatments, exposed or not to a peri-implantitis challenge. Eighty implants with three different surfaces (Straumann BLT [A], Noble Biocare Active [B], Plenum 3D printed titanium implants test [C], and Plenum 3D printed titanium implants served as a negative control [D]) were placed into male minipigs (Minipig Br1) mandibles on both sides. Three months after implant placement, peri-implantitis was induced with cotton ligatures in one side of the mandible, and an intraosseous implant served as a control on both sides. Histometric analysis of marginal bone loss did not present a statistical difference between groups (p>0,05), but regarding Bone to Implant Contact (BIC), the B group presented the highest percentage. The additive manufacturing implant performed like commercially available implants in all the performed analyses, suggesting that additive manufacturing could be an alternative for the fabrication of osseointegrated implants.

O aumento global benéfico no uso de implantes dentários também promove um aumento nas complicações relacionadas ao tratamento. A peri-implantite é uma questão preocupante nesse cenário. Este estudo teve como objetivo comparar o comportamento de um implante produzido por manufatura aditiva com implantes comercialmente disponíveis com diferentes tratamentos de superfície, expostos ou não á indução de peri-implantite. Oitenta implantes com três superfícies diferentes (Straumann BLT [A], Nobel Biocare Active [B], implante confeccionado em impressora 3D Plenum [C] e implante confeccionado em impressora 3D Plenum - usado como controle negativo [D]) foram colocados nas mandíbulas, em ambos os lados, de miniporcos machos (Minipig Br1). Três meses após a instalação dos implantes, a peri-implantite foi induzida com ligaduras de algodão em um dos lados da mandíbula, e um implante intraósseo serviu como controle em ambos os lados. A análise histométrica da perda óssea marginal não apresentou diferença estatística entre os grupos (p>0,05), mas em relação ao Contato Osso-Implante (BIC), o grupo B apresentou a maior porcentagem. O implante produzido por manufatura aditiva teve desempenho semelhante ao dos implantes comercialmente disponíveis em todas as análises realizadas, sugerindo que a manufatura aditiva pode ser uma alternativa para a fabricação de implantes osseointegrados.

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Figures

Figure 1
Figure 1. (A) Dental implants evaluated in the study; from right to left - Straumann, Nobel, Plenum, and the fourth site negative control - submerged Plenum; (B) Dental implant placement in infra-crestal position (2mm depth).
Figure 2
Figure 2. . Dental implants from the test site (with dental plaque accumulation and cotton ligatures). From left to right: Straumann, Nobel, and Plenum. The red arrows depicted the peri-implant bone loss in both buccal and lingual sites.
Figure 3
Figure 3. Dental implants from the control site (without ligatures). From left to right: Straumann, Nobel, and Plenum. Note that the peri-implant bone level surrounds the implant neck.
Figure 4
Figure 4. Box plots of the percentage of peri-implant bone loss from control (without ligature) and test (with ligature and dental plaque accumulation), p<0.05. Implants A, B, C, and D are Straumann, Nobel, Plenum, and Plenum submerged (negative control).
Figure 5
Figure 5. Dot plot of the percentage of BIC area alongside the implant from control (without ligature) and test (with ligature and dental plaque accumulation), p>0.05. Implants A, B, C, and D are Straumann, Nobel, Plenum, and Plenum submerged (negative control).
Figure 6
Figure 6. Dot plot of the percentage of peri-implant density inside the thread area (BBT) alongside the implant from control (without induced periimplantitis) and test (with induced periimplantitis), p>0.05. Implants A, B, C, and D are Straumann, Nobel, Plenum, and Plenum submerged (negative control).
Figure 7
Figure 7. (A) Three-dimensional reconstruction (oblique and top view) of micro CT scans obtained at the test side, with induced periimplantitis, showing a similarity in the marginal bone loss pattern for the tested implant and commercially available brands. (B) Micro CT sample images of implants placed in minipigs' mandibles, with periimplantitis (test). Implants A, B, C, and D are Straumann, Nobel, Plenum, and Plenum submerged (negative control).
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