Preventing Peri-implantitis: The Quest for a Next Generation of Titanium Dental Implants

Abstract

Titanium and its alloys are frequently the biomaterial of choice for dental implant applications. Although titanium dental implants have been utilized for decades, there are yet unresolved issues pertaining to implant failure. Dental implant failure can arise either through wear and fatigue of the implant itself or peri-implant disease and subsequent host inflammation. In the present report, we provide a comprehensive review of titanium and its alloys in the context of dental implant material, and how surface properties influence the rate of bacterial colonization and peri-implant disease. Details are provided on the various periodontal pathogens implicated in peri-implantitis, their adhesive behavior, and how this relationship is governed by the implant surface properties. Issues of osteointegration and immunomodulation are also discussed in relation to titanium dental implants. Some impediments in the commercial translation for a novel titanium-based dental implant from “bench to bedside” are discussed. Numerous in vitro studies on novel materials, processing techniques, and methodologies performed on dental implants have been highlighted. The present report review that comprehensively compares the in vitro, in vivo, and clinical studies of titanium and its alloys for dental implants.

Bio-inspired antimicrobial surfaces fabricated by glancing angle deposition

“…The SEM images show the E. coli are punctured and killed by the surfaces, which is validated by the flat 12-h growth curve of E. coli . The large-area cicada-wing-mimicry antimicrobial surfaces are potentially useful in the food and biomedical industries 32 , 33 .…”

Bench-to-bedside: Feasibility of nano-engineered and drug-delivery biomaterials for bone-anchored implants and periodontal applications

“…It has been reported that ∼18 million implants are sold annually by different companies [ 110 ]. Despite the high rate of successful osseointegration [ 110 ], dental implants and biomaterials related to tissue regeneration still show early and late complications [ [111] , [112] , 113 ] and it promotes the need for innovation, moreover, the dental market has been reported to be growing quickly, showing a prediction of USD 1.3 billion invested on implant/peri-implantitis treatments and over USD 5.7 billions invested on oral treatments involving biomaterials [ 114 , 115 ].…”

Tailoring Ti Grade 2 and TNTZ alloy surfaces in a two-step mechanical–chemical modification

“…So, the search is ongoing for biomaterials that would meet the requirements without being detrimental to human health. Alternatives to Ti-6Al-4 V alloy include commercially pure titanium (cp-Ti) and β-titanium alloys, which contain only non-toxic chemical elements and demonstrate satisfactory biocompatibility [4,8,[13][14][15]. Moreover, β-alloys are characterised by a lower Young's modulus, more similar to that of human bone, which prevents bone atrophy and the loosening of the implant associated with it [11,13,14,16,17].…”

“…This novel β-alloy has been widely investigated in the literature due to its great promise for biomedicine, a result of its very low Young's modulus, good corrosion resistance, biocompatibility, and relatively high phase stability during further manufacturing processes [18][19][20]. However, for both commercially pure titanium and TNTZ β-alloy, there is still a need to improve their mechanical properties, and surface condition [8,21].…”

“…The surface of biomaterials plays an essential role in implant acceptance and integration [5,8,[22][23][24][25][26][27][28][29][30]. This is the region of first contact between an implant and the environment of the human body, and so the surface of the biomaterial should encourage osteoblast cell adhesion and proliferation, inhibit infections through an antibacterial effect, and prevent abrasive wear of the implant [15,30,31].…”