**Treatments to Optimize Dental Implant Surface Topography and Enhance Cell Bioactivity**

Jaume Miranda-Rius, Eduard Lahor-Soler, Lluís Brunet-Llobet, David de Dios and Francesc Xavier Gil

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/62682

#### **Abstract**

Osseointegration is a biological process in which histological, surgical, infectious factors, biomechanical load, and the choice of biomaterials all play important roles. In the case of dental implants, the success of this process is also influenced by the design, composi‐ tion, and properties of the implant surface, which may stimulate cell bioactivity and promote osteoblast adhesion. Currently, the raw materials most frequently used in the manufacture of dental implants are titanium, its alloys, and certain ceramic materials such as zirconia. Multiple macroscopic designs incorporating various diameters, lengths, shapes, and types of screw offer different options for specific clinical situations. The characteristics of implant surfaces have aroused great interest, due to their importance in osseointegration. The different methods used to modify surface properties are classi‐ fied as additive (i.e., impregnation and coating) or subtractive (i.e., physical, mechani‐ cal and chemical methods). The surface characteristics of dental implants also have a significant influence on peri-implant microbiota.

**Keywords:** Dental implant, Titanium, Osseointegration, Surface roughness, Coating, Peri-implantitis

### **1. Introduction**

Over many years, dental implants have been developed and modified in order to achieve an optimal interaction between the body and the implanted material and thus to improve osseointegration and reduce the complications due to colonization of bacterial plaque [1].

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Proper integration of the surface of a dental implant with the surrounding bone is essential to ensure the longevity and function of the prosthesis supported by the implant [2]. The cell adhesion between the bone interface and the implant surface is considered the most biologi‐ cally important stage in the process. This structural and functional integration is influenced by the activity of adjacent cells and by the properties of the implant surface itself.

Some implant surfaces may influence the differentiation and proliferation of osteoblasts and may affect the regulation of the transcription factors responsible for the expression of the genes associated with the formation of the bone matrix. Their use may even shorten the implant integration period [3].

The treatment of a surface can be classified according to mechanical, chemical, and physical processes. In dental implants, the modifications of the outer surface are designed to modify the topography and surface energy. This improves wettability and increases cell growth and proliferation, which eventually accelerates the process of osseointegration [4–7].

The biocompatibility and roughness of the materials are the key features in the interaction between the tissue and osseointegration [8]. In addition, the surface of dental implants can be significantly increased using suitable modification procedures such as additive or subtractive techniques [9, 10].
