Dental News - Clean dental implants essential for clinical success

Dental Tribune International

Mon. 9. March 2015

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COLOGNE, Germany: Dental implant surfaces are continuously being improved to achieve better and faster integration with the bone. However, a study being conducted at the University of Cologne has found that some implants’ surfaces still exhibit irregularities and contaminants, and this could have a negative influence on the clinical success of the implant.

The surface of an implant significantly determines the biological response after insertion and, therefore, has a great influence on osseointegration—the successful integration of the implant with the surrounding tissues. Different treatments of the implant material during production not only affect the surface properties of the implant, but may also leave organic or inorganic residue on its surface.

Researchers at the University of Cologne are currently analysing approximately 100 different implants regarding mechanical precision and surface quality. The study, conducted on behalf of the Quality and Research Committee of the European Association of Dental Implantologists (BDIZ EDI), regularly examines the implants available on the European market. The first study was launched in 2008 and analysed 23 sterile-packaged implants from nine countries. A second study with 57 implants followed in 2012.

Although, according to the researchers, some manufacturers have made substantial improvements since the first examination in 2008, a recent intermediate study report showed that several implants still exhibit topographical irregularities, organic contaminants and inorganic residue from the manufacturing process.

The implants were analysed under a scanning electron microscope and subjected to qualitative and quantitative elemental analyses. From these, the researchers discovered unexpected particles on some of the implants, such as chromium, copper, iron, silicon and tin, and massive organic residue, like plastic material originating from an implant’s low-density polyethylene plastic packaging.

There is insufficient knowledge about the effect of metallic particles or organic residue on sterile implants, but impurities are preventable, explained Dr Dirk Duddeck, study author and head of materials research at the Interdisciplinary Policlinic for Oral Surgery and Implantology at the university. “It is difficult to imagine that those contaminants may have a positive influence on osseointegration, especially in cases with a compromised bone situation,” Duddeck stated.

However, the majority of the analysed implants showed good results. “A very clean implant in this study was provided by Paltop. The manufacturer uses a multistage extensive cleaning process, which was adopted from the semiconductor industry. This cleaning process removes undesirable residue derived from processing, yielding a contamination-free surface,” Duddeck said. Paltop’s surface technology will be presented at the International Dental Show in Cologne at integrated dental systems’ stand (Hall 4.2, Booth N060).

The study, titled “Quantitative and qualitative element-analysis of implant-surfaces by SEM and EDX”, is currently ongoing until end of March 2015. The intermediate study report was published recently in the 1/2015 issue of the European Journal for Dental Implantologists. The journal will be available at the International Dental Show in Cologne at the booth of BDIZ EDI (Hall 11.2, Booth O059).

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Are we playing "Russian Roulette" with our patients? Everything about factory-made contaminants on sterile packaged dental implants

Dr. Dirk U. Duddeck DDS

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