The role of angiogenesis in implant dentistry part I: Review of titanium alloys, surface characteristics and treatments

BACKGROUND Angiogenesis plays an important role in osseointegration process by contributing to inflammatory and regenerative phases of surrounding alveolar bone. The present review evaluated the effect of titanium alloys and their surface characteristics including: surface topography (macro, micro, and nano), surface wettability/energy, surface hydrophilicity or hydrophobicity, surface charge, and surface treatments of dental implants on angiogenesis events, which occur during osseointegration period. MATERIAL AND METHODS An electronic search was performed in PubMed, MEDLINE, and EMBASE databases via OVID using the keywords mentioned in the PubMed and MeSH headings regarding the role of angiogenesis in implant dentistry from January 2000-April 2014. RESULTS Of the 2,691 articles identified in our initial search results, only 30 met the inclusion criteria set for this review. The hydrophilicity and topography of dental implants are the most important and effective surface characteristics in angiogenesis and osteogenesis processes. The surface treatments or modifications of dental implants are mainly directed through the enhancement of biological activity and functionalization in order to promote osteogenesis and angiogenesis, and accelerate the osseointegration procedure. CONCLUSIONS Angiogenesis is of great importance in implant dentistry in a manner that most of the surface characteristics and treatments of dental implants are directed toward creating a more pro-angiogenic surface on dental implants. A number of studies discussed the effect of titanium alloys, dental implant surface characteristic and treatments on agiogenesis process. However, clinical trials and in-vivo studies delineating the mechanisms of dental implants, and their surface characteristics or treatments, action in angiogenesis processes are lagging.