Fabrication of dental implants by the additive manufacturing method: A systematic review

Influence of chemical composition on cell viability on titanium surfaces: A systematic review

STATEMENT OF PROBLEM

A consensus on which dental implant alloy and surface treatment provide the best cell viability is unclear.

PURPOSE

The purpose of this systematic review was to provide information on the influence of surface and intrinsic titanium alloy chemical components on cell viability.

MATERIAL AND METHODS

The PubMed, LILACS, COCHRANE library, and Science Direct databases were electronically searched for the terms dental implants AND titanium AND cytotoxicity. Inclusion criteria were research articles that studied titanium or its alloys for chemical composition and cell viability and were published in English between 1999 and 2019. Articles that did not study titanium and its alloys, articles with nondental or biomedical implants, and articles that were not found in their entirety were excluded.

RESULTS

A total of 1226 articles selected by title or abstract according to the inclusion and exclusion criteria resulted in 51 articles that were reduced to 27 after reading in full. The treatments analyzed were arc fusion, electron beam physical deposition, plasma electrolytic oxidation, coating addition, micro arc oxidation, anodization, thermochemical process, BMP-2 immobilization, pressure-assisted sintering, and alkali heat treatment.

CONCLUSIONS

The evaluated literature did not allow a determination of the best surface treatment for cell viability because of the heterogeneity of the studies regarding the type of alloy, cell used in the MTT assay, study, and implant purpose (biomedical or dental). The cytotoxic effect of chemical components was dependent on dose, time, size, temperature, and cell type. The niobium, tantalum, zirconium, and molybdenum elements have been most often added in the development of less toxic Ti alloys with lower modulus of elasticity and increased strength.

Surface parameters of as-built additive manufactured metal for intraosseous dental implants

STATEMENT OF PROBLEM

To improve osseointegration, current machined implants are submitted to different surface treatments such as airborne-particle abrasion and acid etching. Although additive manufacturing has allowed the fabrication of implants with custom design, porosity, and roughness, whether good osseointegration can be achieved without subsequent surface treatments is still unclear.

PURPOSE

The purpose of this in vitro study was to investigate the feasibility of using additive manufacturing technology for dental implants without the use of subsequent surface treatments.

MATERIAL AND METHODS

The roughness, wettability, and surface energy of a flat test stainless-steel specimen produced from a 3D printer were evaluated. The roughness measurements were obtained by using a mechanical contact profilometer. The wettability was characterized by the sessile drop method by using deionized water and ethylene glycol. The surface energy values were calculated by using the Owens, Wendt, Rabel, and Kaeble (OWRK) computational method.

RESULTS

The experimental data obtained were R_a=4.55 μm, R_q=5.64 μm, R_Sm=0.235 mm, R_sk=-0.071, R_ku=3.740, R_dq=13 degrees; water contact angle=66 degrees; ethylene glycol contact angle=57 degrees; surface energy=38 mN/m. The measured values were compared with data reported in the literature for commercially available implants. The parameter R_a, which is the most used parameter to describe the surface of dental implants, was 50%, 270%, and 329% higher than that reported in the literature for commercial dental implants. The surface energy was 10% and 19% lower than the representative values in the literature for commercial dental implants.

CONCLUSIONS

The results indicate that specimens fabricated by additive manufacturing had higher roughness and lower surface energy than reported results in the literature. Therefore, additive manufacturing was found to produce suitable surface parameters for dental implants, and subsequent surface treatments could be removed from the manufacturing process.