Dental Implant Surfaces - Physicochemical Properties, Biological Performance, and Trends

Pure titanium and titanium alloys are well established standard materials in dental implants because of their favorable combination of mechanical strength, chemical stability, and biocompatibility (Brunette et al., 2001). Integration of titanium implants with the surrounding bone is critical for successful bone regeneration and healing of dental implant. The concept of osseointegration was discovered by Brånemark and his co-worker and, has had a dramatic influence on clinical treatment of oral implants. The first generation of successfully used clinical titanium implants, which were machined with a smooth surface texture, now approach 50 years in clinical use. Since then, implant surfaces have long been recognized to play an important role in molecular interactions, cellular response and osseointegration, and scientists all over the world have developed the second generation implants with surfaces which can accelerate and improve implant osseointegration. These second generation of clinically used implants underwent mechanical blasting coupled or not, with acid etch, bioactive coatings, anodized and, more recently, laser modified surfaces. (Cochran et al., 1998; Jansen et al., 1993; Palmquist et al., 2010; Brånemark et al., 2010 ). These implants have been extensively documented in vivo, including long-term clinical studies and experimental histological and biomechanical evaluation in animal models. For more knowledge in clinical results of commercially available implants the reader is referred to the following literature (Esposito et al., 2005; Esposito et al., 2003; Albrektsson & Wennerberg, 2004b). The main objective for the development of implant surface modifications is to promote osseointegration, with faster and stronger bone formation. This will likely confer better stability during the healing process, which, preferentially, will improve the clinical performance in the area of poor bone quality and quantity. Furthermore, such promotion may, in turn, accelerate the bone healing and thereby allowing immediate or early loading protocols. Recently growing micro and nanotechnology is rapidly advancing surface engineering in implant dentistry. Such advances in surface engineering technologies have resulted in more