Review study compares machined and sandblasted dental implant surfaces
BUDAPEST, Hungary: Previous studies have suggested that surface roughness is one of several key factors that influence the degree of biological integration and success rates of implants. Although attention and utilisation has shifted from machined to sandblasted surfaces, for clinical practice, no sound and strong evidence exists to support the use of sandblasted implants over machined ones. Therefore, researchers from the Semmelweis University in Budapest, compared implant failure and marginal bone loss between the two in a systematic review and meta-analysis.
During the blasting process, ceramic particles such as titanium oxide, aluminium oxide or silica are blasted on to the implant surface at high velocity. The size of the sand particles and their speed when they reach the implant surface are the key parameters that influence surface roughness. Sandblasted implants have a rather irregular, rough surface and machined surfaces are smoother with only shallow grooves.
According to the researchers, several in vitro studies have demonstrated the positive effects of sandblasted surfaces on osseointegration. However, some preclinical and clinical investigations and reviews have indicated that moderately rough surfaces may not perform better. These studies suggest that a rougher surface may modify the properties of biofilm formation and, therefore, bacteria could attach to the surface more easily. Hence, the marginal bone around rough implants may be less stable and more vulnerable to peri-implantitis.
The systematic review included seven studies, involving 362 sandblasted and 360 machined implants. The results indicated an 80 per cent lower risk ratio among sandblasted compared with machined implants after one year of use and a 74 per cent risk ratio after five years of use, respectively. In contrast, there was no significant difference in marginal bone loss between the two implant surfaces after one and five years of use.
The researchers concluded: “This meta-analysis reveals that sandblasting is superior over machined surface in implant failure but not in marginal bone level in healthy subjects. It also points out the need for further randomised clinical trials with large sample size for objective determination of the clinical benefits of certain implant surface modifications.”
The study was conducted in collaboration with the University of Pécs and the University of Szeged, both in Hungary.
The study, titled “Sandblasting reduces dental implant failure rate but not marginal bone level loss: A systematic review and meta-analysis”, was published online on 3 May 2019 in PLOS ONE.