Titanium is the material of choice for dental implants since it is well tolerated by the living tissues. However, the biocompatibility of titanium is dependent upon many other factors like roughness, topography and chemistry of the implant surface.
The primary objective of carrying out surface treatment is to improve the desirable properties yet maintaining the fundamental qualities of the substrate intact. The surface treatment of the dental implants improves the wettability of the implant surface, which in turn helps to increase the bone-to-implant contact (BIC), all the factors cumulatively enhancing the process of osseointegration . Of all the factors, the surface roughness of the titanium dental implants is found to be the most important one accelerating the rate of osseointegration; the later ultimately resulting in better functional stability and reduced treatment time.
Mainly two types of procedures are used for the surface treatment of titanium dental implants. Coating techniques like titanium plasma spraying (TPS) or alumina coating can be used in the additive type of surface treatment. In the subtractive methods, the most commonly used technique is SLA surface treatment that stands for sandblasted, large grit, acid-etched treatment of the surface of titanium dental implants.
Each and every GP implant is individually treated with the SLA technique to improve the surface roughness. To ensure the excellent quality, each implant – the internal hexagon connection SOITM, TOITM, NSITM, SSITM and the Conical connection CCITM by GP Implant Ltd., is tested by scanning electron microscopy and X-ray photo-electron microscopy.
In the SLA method, TiO2 and Al2O3 like particles are used for the abrasion of the surface. It is reported by many authors that 75 µm size aluminum particles can be efficient enough for sandblasting . After this first step, the implant surface is acid etched to create micro roughness. Both these measures ensure that the surface has both, macro pits and micro-pits. Most commonly HCl or H2SO4 solution is used for acid-etching the titanium dental implant surface.
Benefits of the SLA surface treatment of the titanium dental implant:
- The surface of the sandblasted titanium implant has increased roughness and surface irregularities. Also, the subsequent acid etching procedure ensures that the roughness of the surface is increased on both macro as well as micro level.
- Also, the particle size plays an important role during sandblasting . The SLA-treated surface results in increased bone-to-implant contact due to an elevated level of osteoblast proliferation and cellular adhesion at the surface of the dental implant. These factors play a significant role in the process of osseointegration. The rough surface has more surface energy when compared to a smooth surface. Thus, the SLA technique can accelerate as well as improve the process of osseointegration.
- This ultimately improves the mechanical stability of the implant. Thus, the strengthened bone-to-implant bond can sufficiently withstand the shearing forces as well as torsional forces, lengthening the longevity of the implant in the mouth.
- The techniques of early loading of implants like immediate implant placement or immediate-delayed implant placement have shown to be more successful when using an SLA-treated implant .
Multicentric studies were done at universities and private clinics to investigate the efficacy of GP implants treated with SLA technique. The implants were placed, both in the upper jaw and the lower jaw. Immediate implant placement was done in a total of 67 patients, and 190 implants were placed. And the result of this study concluded that a success rate of 98.4% was seen with SLA-treated GP implants.
Thus, the benefits of sandblasting, large grit, acid etching (SLA) technique for titanium dental implants are many, the most important being the increased bone formation on the implant surface, improvement in osseointegration and its clinical efficacy in early or immediate implant loading.
- Rosales-Leal JI, Rodríguez-Valverde MA, Mazzaglia G, et al. Effect of roughness, wettability and morphology of engineered titanium surfaces on osteoblast-like cell adhesion. Colloids and Surfaces A: Physicochemical and Engineering Aspects. 2010 Aug 5;365(1):222-9.
- Wennerberg A. Int. J. Mach. Tools Manuf. 1998;38:657.
- Makkonen T A, Holmberg S, Niemi L, Olsson C, Tammisalo T and Peltola J. Clin. Oral Implants Res. 1997;8:469.
- Fischer K et al. 5-year follow-up RCT in the edentulous maxilla. F Clin Oral Implants Res 2008;19(5):433–441.