Effects of a modified sandblasting surface treatment on topographic and chemical properties of titanium surface

Laser-Induced µ-Rooms for Osteocytes on Implant Surface: An In Vivo Study

Laser processing of dental implant surfaces is becoming a more widespread replacement for classical techniques due to its undeniable advantages, including control of oxide formation and structure and surface relief at the microscale. Thus, using a laser, we created several biomimetic topographies of various shapes on the surface of titanium screw-shaped implants to research their success and survival rates. A distinctive feature of the topographies is the presence of "µ-rooms", which are special spaces created by the depressions and elevations and are analogous to the µ-sized room in which the osteocyte will potentially live. We conducted the comparable in vivo study using dental implants with continuous (G-topography with µ-canals), discrete (S-topography with μ-cavities), and irregular (I-topography) laser-induced topographies. A histological analysis performed with the statistical method (with p-value less than 0.05) was conducted, which showed that G-topography had the highest BIC parameter and contained the highest number of mature osteocytes, indicating the best secondary stability and osseointegration.

Impact of Engineering Surface Treatment on Surface Properties of Biomedical TC4 Alloys under a Simulated Human Environment

The impact of sandblasting, anodic oxidation, and anodic oxidation after sandblasting on the surface structure and properties of titanium alloys was investigated. It was found that the surface treatments had a significant influence on the surface roughness values, contact angle values, Vickers hardness, wear resistance, and corrosion resistance of titanium alloys. The surface roughness of titanium alloys with sandblasting treatment was increased by 67% compared to untreated specimen. The Vickers hardness of titanium alloys treated with anodic oxidation after sandblasting was found to increase from 380.8 HV to 408.5 HV, which was increased by 7.3%. The surface treatments in this work improved the wear resistance of the titanium alloys to some extent, and it can be found that the wear scar width is reduced by up to 18.6%. The corrosion resistance of the titanium alloys was found to improve on anodic oxidation. Sandblasting was found to increase surface roughness and promote the formation of a porous layer during the anodization process, resulting in a slight decrease in corrosion resistance. The corrosion current density was increased by 21% compared to the untreated specimen. The corrosion current density of the titanium alloy treated with anodic oxidation decreased to 7.01 × 10−8 A/cm2. The corrosion current density was decreased by 24% compared to the untreated specimen. The corrosion current density of the titanium alloys treated with anodic oxidation after sandblasting decreased to 7.63 × 10−8 A/cm2. The corrosion current density was decreased by 8.8% compared to the specimen with anodic oxidation. The anodic oxidation provided a hydrophilic property for the surface of Ti alloys, which could show a better osseointegration characteristic than that of sandblasting. The impact of the surface treatments on surface structure and properties of titanium alloys was studied.

Combining Sandblasting, Alkaline Etching, and Collagen Immobilization to Promote Cell Growth on Biomedical Titanium Implants

Our objective in this study was to promote the growth of bone cells on biomedical titanium (Ti) implant surfaces via surface modification involving sandblasting, alkaline etching, and type I collagen immobilization using the natural cross-linker genipin. The resulting surface was characterized in terms topography, roughness, wettability, and functional groups, respectively using field emission scanning electron microscopy, 3D profilometry, and attenuated total reflection-Fourier transform infrared spectroscopy. We then evaluated the adhesion, proliferation, initial differentiation, and mineralization of human bone marrow mesenchymal stem cells (hMSCs). Results show that sandblasting treatment greatly enhanced surface roughness to promote cell adhesion and proliferation and that the immobilization of type I collagen using genipin enhanced initial cell differentiation as well as mineralization in the extracellular matrix of hMSCs. Interestingly, the nano/submicro-scale pore network and/or hydrophilic features on sandblasted rough Ti surfaces were insufficient to promote cell growth. However, the combination of all proposed surface treatments produced ideal surface characteristics suited to Ti implant applications.

Effects of surface sub-micrometer topography following oxalic acid treatment on bone quantity and quality around dental implants in rabbit tibiae

Background

To explore the effects of topographical modification of titanium substrates at submicron level by oxalic acid treatment on bone quality and quantity around dental implants in rabbit tibiae.

Methods

A total of 60 blasted CP-grade IV titanium dental implants were used. Twenty-eight control implant surfaces were treated with a mixture of HCl/H₂SO₄, whereas 28 other test implant surfaces were treated with oxalic acid following HCl/H₂SO₄ treatment. Two randomly selected sets of control or test implants were placed in randomly selected proximal tibiae of 14 female Japanese white rabbits. Euthanasia was performed 4 and 8 weeks post-implant placement. Bone to implant contact (BIC), bone area fraction (BAF), ratios of mature and immature bone to total bone, and the amount and types of collagen fibers were evaluated quantitatively. Two control and two test implants were used to analyze surface characteristics.

Results

Treatment by oxalic acid significantly decreased Sa and increased Ra of test implant surfaces. BIC in test implants was increased without alteration of BAF and collagen contents at 4 and 8 weeks after implant placement when compared with control implants. The ratios of immature and mature bone to total bone differed significantly between groups at 4 weeks post-implantation. Treatment by oxalic acid increased type I collagen and decreased type III collagen in bone matrices around test implants when compared with control implants at 8 weeks after implant placement. The effects of topographical changes of implant surfaces induced by oxalic acid on BAF, mature bone, collagen contents, and type I collagen were significantly promoted with decreased immature bone formation and type III collagen in the later 4 weeks post-implantation.

Conclusions

Treatment of implant surfaces with oxalic acid rapidly increases osseointegration from the early stages after implantation. Moreover, submicron topographical changes of dental implants induced by oxalic acid improve bone quality based on bone maturation and increased production of type I collagen surrounding dental implants in the late stage after implant placement.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40729-020-00275-x.

Effect of surface modification of Ti-6Al-4V alloy by electron cyclotron resonance plasma oxidation

Ti-6Al-4V alloy is used as biomaterials for dental and orthopedic implants because of their excellent biocompatibilities and mechanical properties. However, it is unclear that electron cyclotron resonance (ECR) plasma oxidation can create the oxide films on Ti-6Al-4V alloy surface, and this technique improves the ability of its osseointegration. The purpose of this study was to investigate the characteristics and calcification ability of the oxide films. X-ray diffraction (XRD) peaks of rutile phase were intensified with increasing the temperature. Scanning electron microscopy (SEM) images showed a crater-like structure, and bonding strengths between the substrate and oxide film reached a maximum at 400°C. Calcium phosphate (CaP) compounds after calcification process were identified as octacalcium phosphate (OCP) and precipitation amount was maximized at 400°C. The results suggested that the altered surface of Ti-6Al-4V alloy by ECR plasma oxidation might have the potential of accelerating the ability of its osseointegration through enhancement of OCP.

Biocompatibility and osseointegration of nanostructured titanium dental implants in minipigs

OBJECTIVES

It is well known that surface treatments of dental implants have a great impact on their rate of osseointegration. The aim of this study was to compare the biocompatibility and the bone-implant contact (BIC) of titanium dental implants with different surface treatments.

MATERIAL AND METHODS

Test implants (Biotech Dental) had a nanostructured surface and control implants (Anthogyr) were grit-blasted with biphasic calcium phosphate and acid-etched surface. Both titanium implants were inserted in mandible and maxillary bones of 6 Yucatan minipigs for 4 and 12 weeks (n = 10 implants/group). Biocompatibility and osseointegration were evaluated by non-decalcified histology and back-scattered electron microscopy images.

RESULTS

The reading of histology sections by an antomo-pathologist indicated that the test implants were considered non-irritating to the surrounding tissues and thus biocompatible compared with control implants. The BIC values were higher for test than for control dental implants at both 4 and 12 weeks.

CONCLUSIONS

In summary, the new nanostructured titanium dental implant is considered biocompatible and showed a better osseointegration than the control implant at both 4 and 12 weeks.

Experimental Study for the Stripping of PTFE Coatings on Al-Mg Substrates Using Dry Abrasive Materials

Polytetrafluoroethylene (PTFE) coatings are used in many applications and processing industries. With their use, they wear out and lose properties and must be replaced by new ones if the cost of the element so advises. There are different stripping techniques, but almost all of them are very difficult and require strict environmental controls. It is a challenge to approach the process through efficient and more sustainable techniques. In the present work, we have studied the stripping of PTFE coatings by projection with abrasives (1 step) as an alternative to carbonization + sandblasting procedures (2 steps). For this purpose, different types of abrasives have been selected: brown corundum, white corundum, glass microspheres, plastic particles, and a walnut shell. The tests were performed at pressures from 0.4 to 0.6 MPa on PTFE-coated aluminium substrates of EN AW-5182 H111 alloy. Stripping rates, surface roughness, and substrate hardness have been studied. Scanning electron microscopy (SEM) images of sandblasted specimens have also been obtained. All abrasives improved mechanical and surface properties in one-step vs. two-step processes. The abrasives of plastic and glass microspheres are the most appropriate for the one-step process, which increases the hardness and roughness level Ra in the substrate. Corundum abrasives enable the highest stripping rates.

Effects of cleaning methods for custom abutment surfaces on gene expression of human gingival fibroblasts

The aim of this study was to develop an effective method for cleaning implant abutments made by computer-aided design and computer-aided manufacturing techniques and to investigate the effect of decontamination in vitro. Briefly, a newly developed reagent (PK) and/or vacuum plasma (Plasma) were used to clean the surfaces of zirconia disks, and the effects of this decontamination were evaluated by X-ray photoelectron spectroscopy. Human gingival fibroblasts (HGFs) were cultured on sample disks for 6, 24, and 48 h. We evaluated cell attachment and gene expression of the acute inflammatory cytokines interleukin-6 and vascular endothelial growth factor A, and type 1 collagen. In the PK and PK+Plasma groups, surface contaminants were reduced by washing. In addition, HGF attachments was increased in the PK and PK+Plasma groups. Gene expressions of interleukin-6 and vascular endothelial growth factor A were lower at 6 h. Gene expression of type 1 collagen was increased at all time points after seeding. These results suggest that decontamination of implant abutment surfaces is important in initial HGF attachment and may improve the biological seal of peri-implant soft tissue.

Slotplates revisited - A retrospective analysis

CONTEXT

Slotplates were specifically designed to meet the special requirements of corrective surgeries of the facial skeleton. This design enables small readjustments of bone fragments in the midface and chin area during surgery without complete removal of plates and screws.

OBJECTIVE, DESIGN, AND SETTING

The aim of this study was to compare morbidity rates of slotplates versus meshplates after Le Fort I osteotomy, genioplasty and/or zygoma 'sandwich' osteotomy performed in a tertiary care centre.

RESULTS

The investigators analyzed chart records of 190 patients, including a total of 257 surgeries. Slotplates were used in 109 patients, meshplates in 81 patients. Plate infection rates were 9.2% in the slotplate group and 7.4% in the meshplate group. Twelve patients (11.0%) from the slotplate group underwent plate removal versus four patients (4.9%) from the meshplate group. In total, there were two cases of delayed union, both in the slotplate group, one progressed to non-union.

CONCLUSION

Due to the low study power significant differences between the two types of plates could not be detected. However, there is a slight tendency towards higher morbidity associated with the use of slotplates. The probability of mechanical weakness of the configuration being responsible for the fatigue fractures is also discussed in this article.

A 2-year outcome audit of a versatile orthodontic bone anchor

This study examined complications leading to, or possibly leading to, treatment failure, related to the use of the orthodontic bone anchor (OBA). The OBA is a potential means of providing absolute anchorage and consists of a base-plate fixed with mono-cortical screws, a neck piercing the soft tissues, and a coronal part with conventional orthodontic hooks, tubes or slots. The investigation took the form of a single centre prospective registry at a supra-regional teaching hospital. Eighteen patients (average age 21 years) had one to four OBAs placed between January 2000 and February 2002. Altogether 35 OBAs were placed. Follow-up took place until April 2004. Reasons for placing the OBAs were noted together with any associated complications during the follow-up period. Twenty-three OBAs have been removed so far, four prematurely (one of them before it was taken into use, due to a change of treatment plan enforced by loss of the contralateral OBA). Nineteen were removed as planned after completion of the intended tooth movements. Common (but minor) complications included granulations, acute gingivitis and gingival recession. Light mobility of the OBA was also noted in some cases, but without clinical repercussions. The OBA can be loaded directly, at the level of the orthodontic archwire or more occlusally. It can be placed at any site at the circumference of the jaws, given good quality and thickness of the bony wall. Conventional biomechanical techniques can be applied. However, the failure rate (premature loss of OBA) of 8.6% is considered high, and has necessitated changes in the hardware and protocol.

Hydroxyapatite and silk combination-coated dental implants result in superior bone formation in the peri-implant area compared with hydroxyapatite and collagen combination-coated implants

PURPOSE

The objective of this study was to compare bone formation after installation of uncoated (UC), hydroxyapatite-coated (HA), collagen plus HA-coated (CH), and silk plus HA-coated (SH) implants.

MATERIALS AND METHODS

Implants in the UC group had acid-etched surfaces. Surface coating was applied using the aerosol deposition method. Cellular responses on the coated surfaces were examined with scanning electron microscopy. Cellular responses to the surfaces were studied with the corresponding coated discs and MG63 cells. Subsequently, 3-(4, 5-dimethylthiazole-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and alkaline phosphatase (ALP) assays were performed. Peri-implant bone formation was evaluated with the rabbit tibia model. Twenty-four implants from each group were installed. The animals were sacrificed 6 weeks after implant installation. Peri-implant bone formation and implant-to-bone contact were measured in histologic sections. Significance of differences across groups was evaluated using analysis of variance.

RESULTS

Scanning electron microscopic images showed that the CH and SH groups exhibited cells that appeared more spread out than those in the other groups. The SH group exhibited the highest value in the MTT assay. The CH group exhibited the highest level of ALP activity. Comparisons of these modifications with the acid-etched surfaces showed that the CH and SH groups displayed significantly greater peri-implant bone formation (P < .001).

CONCLUSION

The SH group displayed significantly greater new bone formation and bone-to-implant contact than did the other groups.

Effects of pico-to-nanometer-thin TiO2 coating on the biological properties of microroughened titanium

The independent, genuine role of surface chemistry in the biological properties of titanium is unknown. Although microtopography has been established as a standard surface feature in osseous titanium implants, unfavorable behavior and reactions of osteogenic cells are still observed on the surfaces. To further enhance the biological properties of microfeatured titanium surfaces, this study tested the hypotheses that (1) the surface chemistry of microroughened titanium surfaces can be controllably varied by coating with a very thin layer of TiO(2), without altering the existing topographical and roughness features; and (2) the change in the surface chemistry affects the biological properties of the titanium substrates. Using a slow-rate sputter deposition of molten TiO(2) nanoparticles, acid-etched microroughened titanium surfaces were coated with a TiO(2) layer of 300-pm to 6.3-nm thickness that increased the surface oxygen levels without altering the existing microtopography. The attachment, spreading behavior, and proliferation of osteoblasts, which are considered to be significantly impaired on microroughened surfaces compared with relatively smooth surfaces, were considerably increased on TiO(2)-coated microroughened surfaces. The rate of osteoblastic differentiation was represented by the increased levels of alkaline phosphatase activity and mineral deposition as well as by the upregulated expression of bone-related genes. These biological effects were exponentially correlated with the thickness of TiO(2) and surface oxygen percentage, implying that even a picometer-thin TiO(2) coating is effective in rapidly increasing the biological property of titanium followed by an additional mild increase or plateau induced by a nanometer-thick coating. These data suggest that a super-thin TiO(2) coating of pico-to-nanometer thickness enhances the biological properties of the proven microroughened titanium surfaces by controllably and exclusively modulating their surface chemistry while preserving the existing surface morphology. The improvements in proliferation and differentiation of osteoblasts attained by this chemical modification is of great significance, providing a new insight into how to develop new implant surfaces for better osseointegration, based on the established microtopographic surfaces.

The effect of superficial chemistry of titanium on osteoblastic function

The surface topography and chemistry of titanium are postulated to be two major factors that affect the osseointegration capacity of titanium implants. However, it is extremely difficult to control one factor without changing the other, which prevents the isolation of the genuine effect of one factor. This study aimed to determine whether surface chemistry of titanium alone affects osteoblastic function. Two different titanium surfaces were prepared by sputter depositioning of titanium (Ti; 99.99% purity) or titanium dioxide (TiO2; 99.99% purity) (50-nm thick for each) onto machined commercially pure titanium disks. Rat bone marrow-derived osteoblastic cells were cultured on each of the two surfaces. TiO2 surface showed 4.4 times higher elemental oxygen concentration and higher water wettability than Ti surface. Scanning electron microscopic and atomic force microscopic examination revealed no differences in surface topography and roughness values between the two surfaces. The cell proliferated more on TiO2 than on Ti by up to 60%. Although the expression of collagen I gene increased more rapidly on TiO2 at early culture stage of day 3, the late stage marker genes for osteoblastic differentiation, including osteopontin and osteocalcin, were not modulated between the two cultures. The alkaline phosphatase positive area and mineralized nodule area were approximately two times larger on TiO2 than on Ti. In conclusion, titanium materials having different superficial chemistry, that is, titanium or titanium dioxide, may exert different biological capacity of osteoblasts; titanium dioxide may induce superior osteoconduction, primarily because of the increased osteoblastic proliferation.

Early Tissue Response to Modified Implant Surfaces Using Back Scattered Imaging

PURPOSE

It is now well known that implant surface properties affect osseointegration. Grit-blasting with abrasives and coating by plasma are methods to modify implant surfaces. This study aimed to compare the direction of new bone formation associated with three types of surfaces.

MATERIALS AND METHODS

Titanium (Ti) alloy rods grit-blasted with alumina abrasive (Group 1, G1), with apatitic abrasive (Group 2, G2), and with apatitic abrasive and plasma-sprayed with hydroxyapatite (Group 3, G3) were implanted in surgically created defects in tibias of New Zealand white rabbits for 2 and 4 weeks. After sacrifice, the implants and surrounding bones were obtained and analyzed using back scattered imaging.

RESULTS

Differences in patterns of bone formation among the groups were observed: originating from the cortical bone towards the implant surface (Type A), surrounding the implant (Type B) and originating from the medullary cavity (Type C). G1 and G3 showed Types A and B while G2 exhibited Types A, B and C. After 4 weeks, greater amount of new bone was observed in G2 group compared with those in G1 and G3 groups.

CONCLUSIONS

This study demonstrated that patterns of bone formation are influenced by methods of surface modification.

Influence of implant microstructure on the dynamics of bone healing around immediate implants placed into periodontally infected sites. A confocal laser scanning microscopic study

This study evaluated by fluorescence analysis the influence of implant microstructure on the placement of immediate implants in periodontally infected sockets. Periodontal disease was induced during 12 weeks bilaterally from P1 to P4 in six dogs. The teeth were extracted and immediate implants were placed. Each dog received six implants: three with Friadent experimental surface (grit blasted/acid etched - FES group) and three covered with titanium plasma spray (TPS group), for a total of 36 Frialit-2 stepped cylinder implants. During the healing period, fluorescent bone markers were injected to study the bone remodeling around the implants. The dyes were injected in the following sequence: oxytetracyclin hydrochloride 3 days and 8 weeks, calcein green 4 weeks after the implantation and alizarin red S 3 days before killing. The animals were anesthetized and killed 12 weeks after implant placement. The mandibles were removed, dissected and processed for analyses of the percentage of newly formed bone surrounding the implant using a confocal laser scanning microscope. There were no significant statistical differences in bone formation (Mann-Whitney) between groups (FES group: 5.28% formation at 3 days, 10.3% at 4 weeks, 21.14% at 8 weeks and 6.98% at 12 weeks; TPS group: 3.36% at 3 days, 9.58% at 4 weeks, 14.57% at 8 weeks and 7.08% at 12 weeks). However, covariance analysis showed that the percent of marked bone was statistically greater for the FES group when compared to the TPS group, between the 3-day and 8-week periods of evaluation.

Shear bond strength between titanium alloys and composite resin: sandblasting versus fluoride-gel treatment

The aim of this study was to investigate the effect of fluoride gel treatment on the bond strength between titanium alloys and composite resin, and the effect of NaF solution on the bond strength of titanium alloys. Five titanium alloys and one Co-Cr-Mo alloy were tested. Surface of the alloys were treated with three different methods; SiC polishing paper (No. 2000), sandblasting (50-microm Al2O3), and commercially available acidulated phosphate fluoride gel (F-=1.23%, pH 3.0). After treatment, surfaces of alloy were analyzed by SEM/EDXA. A cylindrical gelatin capsule was filled with a light-curable composite resin. The composite resin capsule was placed on the alloy surface after the application of bonding agent, and the composite resin was light cured for 30 s in four different directions. Shear bond strength was measured with the use of an Instron. Fluoride gel did not affect the surface properties of Co-Cr-Mo alloy and Ni-Ti alloy, but other titanium alloys were strongly affected. Alloys treated with the fluoride gel showed similar bond strengths to the alloys treated with sandblasting. Shear bond strength did not show a significant difference (p<0.05) regardless of treatment time (5, 10, and 20 min) of fluoride gel. After the ultrasonic cleaning subsequent to the fluoride-gel treatment, residues of fluoride ion or any other titanium-fluoride complexes were not detected. NaF solution did not reduce the shear bond strength of titanium alloys. To enhance the bond strength of composite resin to titanium alloys, fluoride-gel treatment may be used as an alternative technique to the sandblasting treatment.

A novel osteosynthesis plate design for routine corrective facial surgery

Plating systems for the osteosynthesis of facial osteotomies have different requirements to those used to treat facial fractures. The aim of fracture treatment is anatomical fragment reduction, functional/rigid immobilization, restoration of occlusion and aesthetics, and occasionally defect bridging. In corrective facial surgery however there is a need for intra-operative adjustments related to changes in occlusion and aesthetics, and defect bridging occurs frequently. Postoperatively, training elastics are used to control temporary neuromuscular imbalance. To accommodate these demands a new plating system is presented, based on five requisites: allowance of occlusal and aesthetic adjustment without hardware removal, plate dimensions that accommodate routine skeletal repositionings, reduced hardware volume compared with trauma plating systems, screws that fit the inter-dental spaces when tension banding, and capability for micro-screw fixation of bone grafts in the osteotomy site. The files of 1000 non-congenital facial deformity patients were analyzed. The sagittal, vertical and transverse movements were drawn and the bridging distances calculated. Slotted plates with double-armed interconnections were designed for maxillary, zygomatic-sandwich, chin and segmental osteotomies. A separate design was made for the sagittal split plate. A pilot study was performed using 20 patients. The system showed great versatility and adaptability, but a multicenter morbidity study is necessary, mainly to study postoperative stability.

Biomechanical comparison of the sandblasted and acid-etched and the machined and acid-etched titanium surface for dental implants

To make a direct biomechanical comparison between the sandblasted and acid-etched surface (SLA) and the machined and acid-etched surface (MA), a well-established animal model for implant removal torque testing was employed, using a split-mouth experimental design. All implants had an identical cylindrical solid-screw shape with the standard ITI thread configuration, without any macroscopic retentive structures. After 4, 8, and 12 weeks of bone healing, removal torque testing was performed to evaluate the interfacial shear strength of each surface type. Results showed that the SLA surface was more powerful in enhancing the interfacial shear strength of implants in comparison with the MA surface. Removal torque values of the SLA-surfaced implants were about 30% higher than those of the MA-surfaced implants (p = 0.002) except at 4 weeks, when the difference was at the threshold of statistical significance (p = 0.0519). The mean removal torque values for the SLA implants were 1.5074 Nm at 4 weeks, 1.8022 Nm at 8 weeks, and 1.7130 Nm at 12 weeks; and correspondingly, 1.1924 Nm, 1.3092 Nm, and 1.3226 Nm for the MA implants. It can be concluded that the SLA surface achieves a better bone anchorage than the MA surface, and that sandblasting before acid etching has a beneficial effect on the interfacial shear strength. As regards the bone-implant interfacial stiffness calculated from the torque-rotation curve, the SLA implants showed an overall more than 5% higher stiffness compared with the MA implants, although the difference did not reach the statistical significance level.

Bone interface of dental implants cytologically influenced by a modified sandblasted surface: a preliminary in vitro study

To study the influences of a modified sandblasted surface (developed by the authors) on the integrating status of titanium (Ti) dental implants and bone in vitro, a three-dimensional experimental model of implant material-osteoblast culture was used. The interaction of Ti discs and osteoblasts at the interface was followed with phase-contrast microscope examination and was further observed histologically and ultra-structurally after one-month culture. Results showed that there was no significant difference between the modified sandblasted surface group and the smooth surface group in the capacity of osteoblasts migrating and attaching to Ti discs. There was, however, a significant difference in the pattern of attachment. Around the polished surface, the migrating and attaching osteoblasts oriented themselves parallel to it; however, around the modified sandblasted surface, the osteoblasts were migrating and attaching perpendicularly. There was also a major difference in the shapes of cells lining the interface; spindle-shaped on the smooth surface versus round and ovoid with a large cellular body and abundant cytoplasm on the modified sandblasted surface. Moreover, transmission electron microscopy revealed an active secretion of collagen fibrils, a bone-matrix-vesicles-mediated mineralization process, and the formation of osteocytes in the modified sandblasted surface group. Therefore, at this in vitro level, it can be concluded that the modified sandblasting surface treatment of dental implants can facilitate bone healing at their osseous interface and enable the real perpendicularly connecting bone-fiber osseointegration to form instead of the capsule-like osseous adaptation.