Implant Stability Development of Photofunctionalized Implants Placed in Regular and Complex Cases: A Case-Control Study

Abstract

The objective of this study was to compare the rate of implant stability development of as-received and photofunctionalized dental implants in regular and complex cases. Materials and Methods: Forty-nine implants (24 as-received and 25 photofunctionalized) placed in regular or complex cases (simultaneous guided bone regeneration, sinus elevation, or fresh extraction sockets) were studied. Photofunctionalization was performed by ultraviolet (UV) treatment of implants for 15 minutes using a photo device immediately prior to placement, and the generation of superhydrophilicity was confirmed. Implant stability was evaluated by measuring the implant stability quotient (ISQ) at placement (ISQ1) and at stage-two surgery (ISQ2). The rate of implant stability development was evaluated by calculating the osseointegration speed index (OSI), defined as the ISQ increase per month ([ISQ2-ISQ1]/healing time in months). The percentage of innate bone support at placement was evaluated clinically and radiographically. Results: The average OSI was considerably greater for photofunctionalized implants (3.7 ± 2.9) than for as-received implants (0.0 ± 1.0). The OSI in complex cases was 4.2 ± 3.2 for photofunctionalized implants and 0.2 ± 0.9 for as-received implants. The OSI in cases with simultaneous sinus elevation was 5.5 ± 3.5 for photofunctionalized implants and 0.2 ± 1.1 for as-received implants. Photofunctionalized implants showed significantly higher ISQ2 values than as-received implants. Photofunctionalized implant ISQ2 values were greater than 60, regardless of primary stability and innate bone support at placement. In multivariate analysis including the effects of photofunctionalization, age and sex of patients, and diameter and length of implants, photofunctionalization showed the strongest influence on the OSI for both regular and complex cases, while other factors influenced the OSI only in certain conditions. Conclusion: Photofunctionalization accelerated the rate and enhanced the final level of implant stability development compared with as-received implants, particularly for implants placed into poor-quality bone and other complex cases. Photofunctionalization was a stronger determinant of implant stability than all the other tested implant-and host-related factors.

An Integrated Overview of Ultraviolet Technology for Reversing Titanium Dental Implant Degradation: Mechanism of Reaction and Effectivity

“…To date, studies on the effect of photofunctionalization in humans, especially randomized controlled trials, are yet to be reported. Currently, only retrospective case controls [100] and case series [58,96] have been reported. Table 5 summarizes the findings from the literature that pertain to the effect of UV light treatment on osseointegration in humans.…”

Tuning of Titanium Microfiber Scaffold with UV-Photofunctionalization for Enhanced Osteoblast Affinity and Function

“…UV-photofunctionalization is more effective on micro-roughened Ti surfaces [5], promoting osteoblast differentiation and rapid osseointegration [9][10][11]. Photofunctionalized dental implants improved a risk of early failure [12] and promised faster and stable osseointegration even in extremely poor conditions [13].…”

Modifications of Dental Implant Surfaces at the Micro- and Nano-Level for Enhanced Osseointegration

“…A previous clinical study showed that the stability of implants inserted into the patients' jaw bones increased more rapidly when the implants were UV-photofunctionalized [121]. The retrospective clinical studies concluded that UV-mediated photofunctionalization reduced early implant failure, and the success rate of the photofunctionalized implants was 97.6% during the functional loading period of approximately 2.5 years [122,123].…”