In a study model that aims to evaluate the effect of nanotopography on bone formation, micrometer structures known to alter bone formation, should be removed. Electropolished titanium implants were prepared to obtain a surface topography in the absence of micro structures, thereafter the implants were divided in two groups. The test group was modified with nanosize hydroxyapatite particles; the other group was left uncoated and served as control for the experiment. Topographical evaluation demonstrated increased nanoroughness parameters for the nano-HA implant and higher surface porosity compared to the control implant. The detected features had increased size and diameter equivalent to the nano-HA crystals present in the solution and the relative frequency of the feature size and diameter was very similar. Furthermore, feature density per microm(2) showed a decrease of 13.5% on the nano-HA implant. Chemical characterization revealed calcium and phosphorous ions on the modified implants, whereas the control implants consisted of pure titanium oxide. Histological evaluation demonstrated significantly increased bone formation to the coated (p < 0.05) compared to uncoated implants after 4 weeks of healing. These findings indicate for the first time that early bone formation is dependent on the nanosize hydroxyapatite features, but we are unaware if we see an isolated effect of the chemistry or of the nanotopography or a combination of both.

In the beginning of implantology, the procedures adopted for treating patients were performed in two surgical phases with an interval of 3-6 months. Nowadays, it is possible to insert and load a dental implant in the same surgical procedure. This change is due to several factors, such as improvement of surgical technique, modifications of the implant design, increased quality of implant manufacturing, development of the surgical instruments' quality, careful patient screening and adequate treatment of the implant surface. The clinical results show that adequate treatment of surfaces is crucial for reducing healing time and treating at-risk patients. The surface properties of dental implants can be significantly improved at the manufacturing stage, affecting cells' activity during the healing phase that will ultimately determine the host tissue response, a fundamental requirement for clinical success. This review focuses on different types of dental implant surfaces and the influence of surface characteristics on osseointegration.

Background: A recently introduced implant, the NobelDirect (Nobel Biocare AB, Göteborg, Sweden), has previously been documented with substantial bone resorption in a large number of operated cases.

Thus, no evidence of enhanced bone formation to nano-HA-modified implants was observed compared to nano-titania-modified implants. The presence of specific nanostructures dependent on the surface modification exhibiting different size and distribution did modulate in vivo bone response.

Background Modern dental implants present surface features of distinct dimensions that can be damaged during the insertion procedure into bone. Purpose The aims of this study were (1) to quantify by means of roughness parameters the surface damage caused by the insertion procedure of dental implants and (2) to investigate the presence of loose particles at the interface. Materials and Methods Three groups of dental implants representing different surface topographies were inserted in fresh cow rib bone blocks. The surface roughness was characterized by interferometry on the same area before and after the insertion. SEM-BSD analysis was used to identify loose particles at the interface. Results The amplitude and hybrid roughness parameters of all three groups were lower after insertion. The surface presenting predominance of peaks (Ssk>0) associated to higher structures (height parameters) presented higher damage associated to more pronounced reduction of material volume. SEM-BSD images revealed loose titanium and aluminum particles at the interface mainly at the crestal cortical bone level. Conclusions Shearing forces during the insertion procedure alters the surface of dental implants. Loose metal particles can be generated at bone-implant interface especially around surfaces composed mainly by peaks and with increased height parameters.

Early bone response to cylindrical smooth titanium implants (S(a)=0.1 microm) inserted into the rabbit tibia was compared in a stable and nonstable regime. Surface roughness parameters were calculated from measurements obtained with optical interferometry and atomic force microscopy. Contrary to our hypothesis, the nonstable implant showed higher bone to metal contact and increased bone area in the endosteal region compared with the stable implant after 4 weeks of healing. Bone area measurements in the cortical region revealed similar values. Primitive woven bone was found in close contact with both implants, but significantly more with the nonstable implant. Finding more bone-to-implant contact (BIC) need not necessarily indicate that unstable implants were more strongly integrated. Primitive bone stage development observed indicates less strong implant anchorage than could be expected from BIC percentage alone. Stable implant design used in this study is a reliable model to evaluate submicron and nanostructures in vivo, as implant stability was achieved in the absence of microirregularaties.

The present study confirms the idea that implant surface modification alters the bone tissue response to titanium. The early bone formation following surgery occurs directly on the moderately rough oxidized surface, while turned titanium surfaces are integrated by the ingrowth of bone from the adjacent bone marrow and preexisting bone tissues.

Objectives The primary aim of this systematic review was to evaluate whether intraoral scanning (IOS) is able to reduce working time and improve patient-reported outcome measures (PROMs) compared to conventional impression (CI) techniques, taking into account the size of the scanned area. The secondary aim was to verify the effectiveness of IOS procedures based on available prosthodontic outcomes. Materials and methods Electronic and manual literature searches were performed to collect evidence concerning the outcomes of IOS and CI performed during the treatment of partially and complete edentulous patients for tooth- or implant-supported restorations. Qualitative analysis was conducted to evaluate the time efficiency and PROMs produced by the two different techniques. Clinical prosthodontic outcomes were analyzed among the included studies when available. Results Seventeen studies (9 randomized controlled trials and 8 prospective clinical studies) were selected for qualitative synthesis. The 17 included studies provided data from 430 IOS and 370 CI performed in 437 patients. A total of 7 different IOS systems and their various updated versions were used for digital impressions. The results demonstrated that IOS was overall faster than CI independent of whether quadrant or complete-arch scanning was utilized, regardless of the nature of the restoration (tooth or implant supported). IOS was generally preferred over CI regardless of the size of the scanned area and nature of the restoration (tooth- or implant-supported). Similar prosthodontic outcomes were reported for workflows implementing CI and IOS. Conclusions Within the limitations of this systematic review, IOS is faster than CI, independent of whether a quadrant or complete arch scan is conducted. IOS can improve the patient experience measured by overall preference and comfort and is able to provide reliable prosthodontic outcomes. Clinical relevance Reduced procedure working time associated with the use of IOS can improve clinical efficiency and the patient experience during impression procedures. Patient-reported outcome measures (PROMs) are an essential component of evidence-based dental practice as they allow the evaluation of therapeutic modalities from the perspective of the patient. IOS is generally preferred by patients over conventional impressions. Supplementary Information The online version contains supplementary material available at 10.1007/s00784-021-04157-3.