Summary of The Osseointegration and Stability of Dental Implants with Different Surface Treatments in Animal Models

Summary of The Osseointegration and Stability of Dental Implants with Different Surface Treatments in Animal Models: A Network Meta-Analysis

Dental implants are artificial tooth roots that are inserted into the jawbone to support prosthetic teeth. Dental implants are widely used to restore missing teeth and improve oral function and aesthetics. However, the success of dental implants depends largely on their ability to integrate with the surrounding bone tissue, a process known as osseointegration. Osseointegration is influenced by various factors, such as the implant design, material, and surface treatment.

The implant surface plays a critical role in promoting osseointegration and implant stability, as it determines the initial contact and interaction between the implant and the bone cells. Different surface treatments can modify the physical and chemical properties of the implant surface, such as roughness, hydrophilicity, topography, and bioactivity. These properties can affect the biological response of the bone tissue to the implant, such as cell adhesion, proliferation, differentiation, and matrix formation.

There are four commonly used dental implants with different surface treatments in clinical practice: SLA, SLActive, TiUnite, and Osseotite. SLA has a rough surface that is produced by sandblasting with large grit followed by acid etching. SLActive has a similar surface to SLA but with higher hydrophilicity and wettability. TiUnite has a moderately rough surface that is produced by anodic oxidation. Osseotite has a nanometer-scale rough surface that is produced by dual acid etching.

The aim of this study was to compare the osseointegration and stability of these four dental implants in animal models using a network meta-analysis. A network meta-analysis is a statistical method that can combine direct and indirect evidence from multiple studies to compare multiple interventions simultaneously.

The study followed the PRISMA and Cochrane guidelines for conducting a systematic review and meta-analysis. The authors searched four databases (Medline, Cochrane Library, Embase, and Web of Science) for randomized controlled trials that compared the osseointegration and stability of SLA, SLActive, TiUnite, and Osseotite implants in animal models. The authors included 12 studies in their analysis, 11 studies for osseointegration and five studies for stability (four studies were used for both outcomes).

The authors measured osseointegration by the bone-to-implant contact (BIC) value, which is the percentage of implant surface that is in direct contact with bone tissue under a microscope. The authors measured stability by the removal torque (RTQ) value, which is the force required to unscrew the implant from the bone.

The authors performed a network meta-analysis using a Bayesian framework to estimate the relative effects of each implant on osseointegration and stability. The authors also ranked the implants according to their probability of being the best or worst for each outcome.

The results of the study showed that:

• For osseointegration at an early healing stage (2–4 weeks), SLActive was significantly better than SLA, TiUnite, and Osseotite in terms of BIC value. SLActive had a 97% probability of being the best implant for early osseointegration.
• For osseointegration at an intermediate healing stage (6–8 weeks), TiUnite was significantly better than SLA and Osseotite in terms of BIC value. TiUnite had an 87% probability of being the best implant for intermediate osseointegration.
• For osseointegration at a late healing stage (12–16 weeks), there was no significant difference among the four implants in terms of BIC value. TiUnite had a 54% probability of being the best implant for late osseointegration.
• For stability at any healing stage (2–16 weeks), TiUnite was significantly better than SLA, SLActive, and Osseotite in terms of RTQ value. TiUnite had a 99% probability of being the best implant for stability.

The study concluded that SLActive had the best effect on osseointegration at an early healing stage, while TiUnite had the best effect on osseointegration at an intermediate or late healing stage and on stability at any healing stage. The study suggested that these effects may be related to the different physical and chemical properties of each implant surface that influence the biological response of the bone tissue. The study also suggested that these results may have implications for the clinical selection and application of dental implants.