Gingival Response to Dental Implant: Comparison Study on the Effects of New Nanopored Laser-Treated vs. Traditional Healing Abutments

Abstract

The health of peri-implant soft tissues is important for the long-term success rate of dental implants and the surface topography is pivotal in influencing it. Thus, the aim of this study was to evaluate, in human patients, the inflammatory mucosal microenvironment in the tissue surrounding a new, nanoscale, laser-treated healing abutment characterized by engineered nanopores versus a standard machined-surface. Analyses of anti- and pro-inflammatory markers, cytokeratins, desmosomal proteins and scanning electron microscopy were performed in 30 soft-tissue biopsies retrieved during second-stage surgery. The results demonstrate that the soft tissue surrounding the laser-treated surface was characterized by a lower grade of inflammation than the one facing the machined-surface, which, in turn, showed a disrupted epithelium and altered desmosomes. Moreover, higher adhesion of the epithelial cells on the laser-treated surface was detected compared to the machined one. In conclusion, the laser-treated surface topography seems to play an important role not only in cell adhesion, but also on the inflammatory makers’ expression of the soft tissue microenvironment. Thus, from a clinical point of view, the use of this kind of topography may be of crucial importance not only on healing abutments but also on prosthetic ones.

Three interfaces of the dental implant system and their clinical effects on hard and soft tissues

“…5,182 Clinical investigations are lacking and are needed to verify the effect of abutment surface treatment on the soft tissue seal, which safeguards the implant from bacterial invasion and periimplantitis. 202 Please do not adjust margins Please do not adjust margins…”

“…Micro-and nanotechnology have been applied to the transmucosal surface of the abutment to enhance the soft tissue seal. 161,201,202 Various surface treatments can alter the surface topography or characteristics, including machining, blasting, plasma spraying, chemical or electrochemical etching, laser treatment, and others. 161 Some animal studies revealed higher attachment of connective tissue on a laser-grooved Ti abutment, when compared to the turned smooth-surfaced Ti abutment.…”

“…210 Nanotechnologically, photofunctionalization by ultraviolet rays, coating cell adhesive molecules including poly-L-lysine and nanoporous modification of abutment surfaces were also reported to strengthen the soft tissue seal around the abutments. 201,202,211 In one in vitro study, Yang et al showed that gingival fibroblasts proliferate more strongly on smooth or rough zirconia surfaces following ultraviolet irradiation. 212 Epithelial attachment was also improved on both the abutment surfaces with poly-L-lysine coating and with laser-induced micro-or nano-pores that were within 5 mm in diameter.…”

“…212 Epithelial attachment was also improved on both the abutment surfaces with poly-L-lysine coating and with laser-induced micro-or nano-pores that were within 5 mm in diameter. 201,202 Abutment surface modification can improve the soft tissue seal. However, more plaque may accumulate on treated surfaces when the seal is broken.…”

“…212 Epithelial attachment was also improved on both the abutment surfaces with poly- l -lysine coating and with laser-induced micro- or nano-pores that were within 5 μm in diameter. 201,202…”