Update Oberflächenanalysen: steril verpackte Implantate unter der Lupe

Die initiale Phase der biologischen Antwort auf ein inseriertes Implantat wird maßgeblich von der Oberfläche eines dentalen Implantats determiniert. Die Eigenschaften dieser Implantatoberfläche sind wesentlicher Faktor für die reizlose Einbindung in umliegende Gewebestrukturen [1]. Dabei hängt die ungestörte Osteoblastenproliferation und Osteoblastendifferenzierung an der Implantatoberfläche ganz entscheidend von der Mikrostruktur dieser Oberfläche ab [2]. Seit den 1980er-Jahren werden aber auch Forderungen nach einer besseren Sauberkeit der eingesetzten Implantatsysteme lauter [3]. Es liegt also nahe, sich nicht nur mit den Implantatwerkstoffen und deren Oberflächenmodifikationen auseinanderzusetzen, sondern auch einen kritischen Blick auf den aktuellen Stand der Oberflächenanalytik und auf die Ergebnisse einer neuen, bislang unveröffentlichten Qualitätsbewertungsstudie von marktgängigen Implantatsystemen zu werfen.

Kernaussagen

• Analysen von steril verpackten Titan- und Keramikimplantaten belegen teilweise erhebliche Fertigungsmängel.

• Werksseitige Verunreinigungen können zu unkontrollierten Fremdkörperreaktionen, periimplantären Entzündungsprozessen bis hin zum Verlust des Implantates beitragen.

• Eine unabhängige Überprüfung der chargenübergreifenden Qualität kann Orientierung für Implantologen und Sicherheit für Patienten bieten.

Publication History

Article published online:
22 August 2022

• Literatur

• 1 Davies JE. Mechanisms of endosseous integration. Int J Prosthodont 1998; 11: 391-401
• 2 Kieswetter K, Schwartz Z, Dean DD. et al. The role of implant surface characteristics in the healing of bone. Crit Rev Oral Biol Med 1996; 7: 329-345 DOI: 10.1177/10454411960070040301.
• 3 Wahl G, Tuschewitzki G-J. Verunreinigungen auf Implantatoberflächen vor der Insertion. Z Zahnärztl Implantol 1987; III: 255-260
• 4 Branemark PI. Vital microscopy of bone marrow in rabbit. Scand J Clin Lab Invest 1959; 11 (Suppl. 38) 1-82
• 5 Pjetursson BE, Heimisdottir K. Dental implants – are they better than natural teeth?. Eur J Oral Sci 2018; 126 Suppl 1: 81-87 DOI: 10.1111/eos.12543.
• 6 Dohan Ehrenfest DM, Coelho PG, Kang BS. et al. Classification of osseointegrated implant surfaces: materials, chemistry and topography. Trends Biotechnol 2010; 28: 198-206 DOI: 10.1016/j.tibtech.2009.12.003.
• 7 Delgado-Ruiz R, Romanos G. Potential Causes of Titanium Particle and Ion Release in Implant Dentistry: A Systematic Review. Int J Mol Sci 2018; 19: 3585 DOI: 10.3390/ijms19113585.
• 8 Mathew MT, Abbey S, Hallab NJ. et al. Influence of pH on the tribocorrosion behavior of CpTi in the oral environment: synergistic interactions of wear and corrosion. J Biomed Mater Res B Appl Biomater 2012; 100: 1662-1671 DOI: 10.1002/jbm.b.32735.
• 9 Mathew MT, Barao VA, Yuan JC. et al. What is the role of lipopolysaccharide on the tribocorrosive behavior of titanium?. J Mech Behav Biomed Mater 2012; 8: 71-85 DOI: 10.1016/j.jmbbm.2011.11.004.
• 10 Mouhyi J, Dohan Ehrenfest DM, Albrektsson T. The peri-implantitis: implant surfaces, microstructure, and physicochemical aspects. Clin Implant Dent Relat Res 2012; 14: 170-183 DOI: 10.1111/j.1708-8208.2009.00244.x.
• 11 Soler MD, Hsu SM, Fares C. et al. Titanium Corrosion in Peri-Implantitis. Materials (Basel) 2020; 13: 5488 DOI: 10.3390/ma13235488.
• 12 Comino-Garayoa R, Cortes-Breton Brinkmann J, Pelaez J. et al. Allergies to Titanium Dental Implants: What Do We Really Know about Them? A Scoping Review. Biology (Basel) 2020; 9: 404 DOI: 10.3390/biology9110404.
• 13 Noronha Oliveira M, Schunemann WVH, Mathew MT. et al. Can degradation products released from dental implants affect peri-implant tissues?. J Periodontal Res 2018; 53: 1-11 DOI: 10.1111/jre.12479.
• 14 Aparicio C, Manresa C, Francisco K. et al. Zygomatic implants: indications, techniques and outcomes, and the zygomatic success code. Periodontol 2000 2014; 66: 41-58 DOI: 10.1111/prd.12038.
• 15 Malchiodi L, Ricciardi G, Salandini A. et al. Influence of crown-implant ratio on implant success rate of ultra-short dental implants: results of a 8- to 10-year retrospective study. Clin Oral Investig 2020; 24: 3213-3222 DOI: 10.1007/s00784-020-03195-7.
• 16 Taheri M, Akbari S, Shamshiri AR. et al. Marginal bone loss around bonelevel and tissue-level implants: A systematic review and meta-analysis. Ann Anat 2020; 231: 151525 DOI: 10.1016/j.aanat.2020.151525.
• 17 de Medeiros RA, Pellizzer EP, Vechiato Filho AJ. et al. Evaluation of marginal bone loss of dental implants with internal or external connections and its association with other variables: A systematic review. J Prosthet Dent 2016; 116: 501-506.e5 DOI: 10.1016/j.prosdent.2016.03.027.
• 18 Ozkurt Z, Kazazoglu E. Clinical success of zirconia in dental applications. J Prosthodont 2010; 19: 64-68 DOI: 10.1111/j.1532-849X.2009.00513.x.
• 19 Sandhaus S. Biometallurgische und zytotoxikologische Untersuchungen bei Implantaten [Biometallic and cytotoxicologic studies of implants]. Zahnarztl Prax 1976; 27: 12-14
• 20 Andreiotelli M, Kohal RJ. Fracture strength of zirconia implants after artificial aging. Clin Implant Dent Relat Res 2009; 11: 158-166 DOI: 10.1111/j.1708-8208.2008.00105.x.
• 21 Roehling S, Schlegel KA, Woelfler H. et al. Zirconia compared to titanium dental implants in preclinical studies-A systematic review and meta-analysis. Clin Oral Implants Res 2019; 30: 365-395 DOI: 10.1111/clr.13425.
• 22 Cosgarea R, Gasparik C, Dudea D. et al. Peri-implant soft tissue colour around titanium and zirconia abutments: a prospective randomized controlled clinical study. Clin Oral Implants Res 2015; 26: 537-544 DOI: 10.1111/clr.12440.
• 23 Cionca N, Hashim D, Cancela J. et al. Pro-inflammatory cytokines at zirconia implants and teeth. A cross-sectional assessment. Clin Oral Investig 2016; 20: 2285-2291 DOI: 10.1007/s00784-016-1729-z.
• 24 Bollen CM, Papaioanno W, Van Eldere J. et al. The influence of abutment surface roughness on plaque accumulation and periimplant mucositis. Clin Oral Implants Res 1996; 7: 201-211
• 25 Bollen CM. Zirconia: the material of choice in implant dentistry? an update. J Dent Health Oral Disord Ther 2017; 6: 172-175
• 26 Edelhoff D, Schweiger J, Prandtner O. et al. Metal-free implantsupported single-tooth restorations. Part II: Hybrid abutment crowns and material selection. Quintessence Int 2019; 50: 260-269 DOI: 10.3290/j.qi.a42099.
• 27 Poggio CE, Ercoli C, Rispoli L. et al. Metal-free materials for fixed prosthodontic restorations. Cochrane Database Syst Rev 2017; (12) CD009606 DOI: 10.1002/14651858.CD009606.pub2.
• 28 Rupp F, Liang L, Geis-Gerstorfer J. et al. Surface characteristics of dental implants: A review. Dent Mater 2018; 34: 40-57 DOI: 10.1016/j.dental.2017.09.007.
• 29 Buser D, Janner SF, Wittneben JG. et al. 10-year survival and success rates of 511 titanium implants with a sandblasted and acid-etched surface: a retrospective study in 303 partially edentulous patients. Clin Implant Dent Relat Res 2012; 14: 839-851 DOI: 10.1111/j.1708-8208.2012.00456.x.
• 30 Albrektsson T, Wennerberg A. Oral implant surfaces: Part 2-review focusing on clinical knowledge of different surfaces. Int J Prosthodont 2004; 17: 544-564
• 31 Shibata Y, Tanimoto Y. A review of improved fixation methods for dental implants. Part I: Surface optimization for rapid osseointegration. J Prosthodont Res 2015; 59: 20-33 DOI: 10.1016/j.jpor.2014.11.007.
• 32 Smeets R, Stadlinger B, Schwarz F. et al. Impact of Dental Implant Surface Modifications on Osseointegration. Biomed Res Int 2016; 2016: 6285620 DOI: 10.1155/2016/6285620.
• 33 Mendonca G, Mendonca DB, Aragao FJ. et al. Advancing dental implant surface technology-from micron- to nanotopography. Biomaterials 2008; 29: 3822-3835
• 34 Webster TJ, Ejiofor JU. Increased osteoblast adhesion on nanophase metals: Ti, Ti6Al4V, and CoCrMo. Biomaterials 2004; 25: 4731-4739 DOI: 10.1016/j.biomaterials.2003.12.002.
• 35 Terheyden H, Lang NP, Bierbaum S. et al. Osseointegration-communication of cells. Clin Oral Implants Res 2012; 23: 1127-1135 DOI: 10.1111/j.1600-0501.2011.02327.x.
• 36 Liu Y, de Groot K, Hunziker EB. Osteoinductive implants: the mise-en-scène for drug-bearing biomimetic coatings. Ann Biomed Eng 2004; 32: 398-406 DOI: 10.1023/b:abme.0000017536.10767.0f.
• 37 Bona AD, Pecho OE, Alessandretti R. Zirconia as a Dental Biomaterial. Materials (Basel) 2015; 8: 4978-4991 DOI: 10.3390/ma8084978.
• 38 Yin L, Nakanishi Y, Alao AR. et al. A review of engineered zirconia surfaces in biomedical applications. Procedia CIRP 2017; 65: 284-290 DOI: 10.1016/j.procir.2017.04.057.
• 39 Brezavscek M, Fawzy A, Bachle M. et al. The Effect of UV Treatment on the Osteoconductive Capacity of Zirconia-Based Materials. Materials (Basel) 2016; 9: 958 DOI: 10.3390/ma9120958.
• 40 Hafezeqoran A, Koodaryan R. Effect of Zirconia Dental Implant Surfaces on Bone Integration: A Systematic Review and Meta-Analysis. Biomed Res Int 2017; 2017: 9246721 DOI: 10.1155/2017/9246721.
• 41 Hao L, Lawrence J, Chian KS. Osteoblast cell adhesion on a laser modified zirconia based bioceramic. J Mater Sci Mater Med 2005; 16: 719-726 DOI: 10.1007/s10856-005-2608-3.
• 42 Oliva J, Oliva X, Oliva JD. Five-year success rate of 831 consecutively placed Zirconia dental implants in humans: a comparison of three different rough surfaces. Int J Oral Maxillofac Implants 2010; 25: 336-344
• 43 Liu YT, Lee TM, Lui TS. Enhanced osteoblastic cell response on zirconia by bio-inspired surface modification. Colloids Surf B Biointerfaces 2013; 106: 37-45 DOI: 10.1016/j.colsurfb.2013.01.023.
• 44 Schunemann FH, Galarraga-Vinueza ME, Magini R. et al. Zirconia surface modifications for implant dentistry. Mater Sci Eng C Mater Biol Appl 2019; 98: 1294-1305 DOI: 10.1016/j.msec.2019.01.062.
• 45 Duddeck DU, Albrektsson T, Wennerberg A. et al. On the Cleanliness of Different Oral Implant Systems: A Pilot Study. J Clin Med 2019; 8 DOI: 10.3390/jcm8091280.
• 46 Hallab NJ, Jacobs JJ. Biologic effects of implant debris. Bull NYU Hosp Jt Dis 2009; 67: 182-188
• 47 Matthews JB, Besong AA, Green TR. et al. Evaluation of the response of primary human peripheral blood mononuclear phagocytes to challenge with in vitro generated clinically relevant UHMWPE particles of known size and dose. J Biomed Mater Res 2000; 52: 296-307 DOI: 10.1002/1097-4636(200011)52:2<296::aid-jbm8>3.0.co;2-9.
• 48 Rader CP, Sterner T, Jakob F. et al. Cytokine response of human macrophage-like cells after contact with polyethylene and pure titanium particles. J Arthroplasty 1999; 14: 840-848 DOI: 10.1016/s0883-5403(99)90035-9.
• 49 Shanbhag AS, Bailey HO, Hwang DS. et al. Quantitative analysis of ultrahigh molecular weight polyethylene (UHMWPE) wear debris associated with total knee replacements. J Biomed Mater Res 2000; 53: 100-110 DOI: 10.1002/(sici)1097-4636(2000)53:1<100::aid-jbm14>3.0.co;2-4.
• 50 Duddeck D, Albrektsson T, Wennerberg A. et al. CleanImplant Trusted Quality Mark 2017–2018 – Guideline and Consensus Paper [PDF Document of Consensus] 2017. Im Internet (Stand: 04.04.2022): https://www.cleanimplant.org%22%3ehttps://www.cleanimplant.org%3c/uri%3e
• 51 Norton MR. Will any dental implant do?. Br Dent J 2020; 228: 243-244 DOI: 10.1038/s41415-020-1302-7.
• 52 Duddeck DU, Albrektsson T, Wennerberg A. et al. Quality Assessment of Five Randomly Chosen Ceramic Oral Implant Systems: Cleanliness, Surface Topography, and Clinical Documentation. Int J Oral Maxillofac Implants 2021; 36: 863-874 DOI: 10.11607/jomi.8837.
• 53 Albrektsson T, Gottlow J, Meirelles L. et al. Survival of NobelDirect implants: an analysis of 550 consecutively placed implants at 18 different clinical centers. Clin Implant Dent Relat Res 2007; 9: 65-70 DOI: 10.1111/j.1708-8208.2007.00054.x.