On the Cleanliness of Different Oral Implant Systems: A Pilot Study

Abstract

(1) Background: This paper aimed to compare the cleanliness of clinically well-documented implant systems with implants providing very similar designs. The hypothesis was that three well-established implant systems from Dentsply Implants, Straumann, and Nobel Biocare were not only produced with a higher level of surface cleanliness but also provided significantly more comprehensive published clinical documentation than their correspondent look-alike implants from Cumdente, Bioconcept, and Biodenta, which show similar geometry and surface structure. (2) Methods: Implants were analyzed using SEM imaging and energy-dispersive X-ray spectroscopy to determine the elemental composition of potential impurities. A search for clinical trials was carried out in the PubMed database and by reaching out to the corresponding manufacturer. (3) Results: In comparison to their corresponding look-alikes, all implants of the original manufacturers showed—within the scope of this analysis—a surface free of foreign materials and reliable clinical documentation, while the SEM analysis revealed significant impurities on all look-alike implants such as organic residues and unintended metal particles of iron or aluminum. Other than case reports, the look-alike implant manufacturers provided no reports of clinical documentation. (4) Conclusions: In contrast to the original implants of market-leading manufacturers, the analyzed look-alike implants showed significant impurities, underlining the need for periodic reviews of sterile packaged medical devices and their clinical documentation.

Influence of the Titanium Implant Surface Treatment on the Surface Roughness and Chemical Composition

“…The residues or particles originated from the different processes used for surface treatment can remain attached to the surface of the titanium and cause some biological effects. These impurities coming from manufacturing or packaging processes may remain on the implant depending on the cleanliness process developed by the manufacturer [37].…”

Achievements in the Topographic Design of Commercial Titanium Dental Implants: Towards Anti-Peri-Implantitis Surfaces

“…Inflammatory cells are attracted to the infected site and proinflammatory cytokines are produced, which further boost osteoclastogenesis [118]. In sum, the immune system inflammatory reaction could be triggered by the presence of metal particles, cement residues, and organic contaminants non-covalently bonded to the surface [119]. These results become a problem when they exceed more than a 10-µm size or are high in numbers because macrophages are unable to phagocytize them and an overproduction of proinflammatory cytokines around the implant takes place, thus increasing the risk of developing peri-implantitis [120,121].…”

Preventing aluminium oxide contamination of dental implant surfaces

“…Previous studies show that different sterile-packaged implant systems with organic and inorganic contaminations on their surfaces abound in the market. This is backed by the pilot study conducted by Duddeck et al (2019) which compared the cleanliness of different oral implant systems in the market. The study concluded that lookalike implants revealed significantly higher impurities when compared to original implants of market-leading manufacturers.…”