Implant surface characteristics and their effect on osseointegration

Key Points Explores the effect of various dental implant surfaces on osseointegration. Explains different materials, designs and surface characteristics that are available for dental implants. Discusses the techniques that are used to modify dental implant surfaces to provide more predictable outcomes. Aim The aim of this literature review is to find current knowledge of dental implants focusing on materials, designs and surface modifications and to understand which implant surfaces have more predictable clinical outcomes. Research material and methods An electronic search using PubMed/Medline, Scopus and The Cochrane Library databases from 1950 onwards was conducted using keywords and terms. Published papers were then obtained online or from specialist libraries. References from individual published papers were also searched for relevant publications. Results Different designs, materials and methods to modify surfaces of implants have been discussed in this paper. Many laboratory studies using animal models reported improved biological outcomes with surface modification of implants at the microscopic level. Despite pure titanium being commercially the prime material of choice, ceramics have the potential to become the next generation of dental implants. Presently there is not sufficient scientific evidence for routine use of ceramic implants. Conclusions Pure titanium is the ideal material for implants. Rough implant surfaces are believed to deliver better osseointegration compared with smooth surfaces however, results from different studies vary. It is not clear which combination of different surface modifications provide a more predictable outcome. More standardised high quality prospective studies are required to prove which implant surfaces have the optimum properties for replacing missing teeth.