A importância da macrogeometria e da morfologia de superfície no sucesso a longo prazo de implantes osseointegráveis – estudo in vitro

José Henrique Cavalcanti de Lima
Departamento de Implantodontia – Centro Carioca de Reabilitação Oral

Beatriz Fernandes de Azevedo Pinheiro
Departamento de Implantodontia – Centro Carioca de Reabilitação Oral

Patrícia Cristina Matos Robbs
Departamento de Clínica Odontológica, Periodontia – Faculdade de Odontologia/Universidade Federal do Rio de Janeiro
ORCID: 0009-0008-3622-4715

Carlos Nelson Elias
Departamento de Biomateriais – Instituto Militar de Engenharia
ORCID: 0000-0002-7560-6926

DOI: https://doi.org/10.71440/2675-5610.10.4.25.496-500.art

RESUMO

Objetivos: investigar as propriedades da superficie de um sistema de implantes nacional. Material e Métodos: Neste estudo, implantes dentários osseointegráveis (3,75 × 10 mm, SysthexR) foram usados. A topografia de superficie foi analisada em microscopia eletronica de varredura (MEV). Os parâmetros de rugosidade Ra e Rq foram obtidos em modo 3D com um perfilometro óptico por interferometria (Zygo New View 7100), e a molhabilidade das superfícies foi investigada no tensiometro pela técnica da gota séssil. Para verificação da viabilidade e interacao celular, células murinas pré-osteoblásticas MC3T3-E1 (ATCC 7594) foram semeadas sobre as superfícies dos implantes a 37 °C, em atmosfera de 5% de CO₂, sendo as imagens analisadas depois de 48 horas de cultivo. Em seguida, dados quantitativos (número e morfologia dos picos e vales) e qualitativos (imagens por MEV em aumento 10.000 vezes) foram obtidos e interpretados conforme critérios internacionais padronizados. Resultados: As superfícies do implante analisado foram consideradas rugosas e homogêneas (Ra = 0,946 ± 0,06 μm e Rq = 1,196 ± 0,07 μm). As variações dos picos e vales também estiveram dentro dos limites estabelecidos na literatura publicada. A capacidade hidrofílica (θ < 90°) também foi demonstrada. A viabilidade e o espraiamento celular sobre a superficie microrugosa foram uniformes. Conclusão: todas as características macro geométricas do implante analisado se enquadram nos parâmetros conceituais modernos para a osseointegracao e o sucesso clinico.

Palavras-chave: tratamento de superficie, implantes osseointegraveis, macrogeometria.

The importance of the dental implant morphology and macrogeometry on the long-term success for osseointegration – in vitro study

ABSTRACT

Objectives: to investigate the surface properties of a national dental implant system. Material and Methods: In this study, osseointegrated dental implants (3.75 × 10 mm, SysthexR) were analyzed. The surface topography was screened by scanning electron microscopy (SEM). Also, the roughness parameters (Ra and Rq) were obtained in a 3D interferometry mode (Zygo New View 7100 optical profiler), and the surface wettability was measured by the sessile drop technique under a tensiometer device. To verify the cell viability and its interactions, MC3T3-E1 murine pre-osteoblastic samples (ATCC 7594) were seeded across the dental implant surfaces and cultivated at 37 °C under a 5% CO₂ atmosphere, with the images analyzed after 48 hours. Next, quantitative (peak and valley number and morphology) and qualitative (SEM images at 10,000× magnification) data were obtained and interpreted according to international standardized criteria. Results: The implant surfaces were considered rough and homogeneous (Ra = 0.946 ± 0.06 μm and Rq = 1.196 ± 0.07 μm). The variations in peaks and valleys were also within those limits established in the published literature. Its hydrophilic nature (θ < 90°) was also demonstrated. The viability and cell spreading across this micro-rough and homogeneous surface were uniform. Conclusion: All the macrogeometric features of the analyzed dental implant system are compatible with modern contemporary concepts for osseointegration and clinical success.

Keywords: surface treatment, osseointegrated implants, macrogeometry

Referências

Gittens RA, Olivares-Navarrete R, Schwartz Z, Boyan BD. Implant osseointegration and the role of microroughness and nanostructures: lessons for spine implants. Acta Biomater. 2014 Aug;10(8):3363-71. https://doi.org/10.1016/j.actbio.2014.03.037

Keller JC, Schneider GB, Stanford CM, Kellogg B. Effects of implant microtopography on osteoblast cell attachment. Implant Dent. 2003;12(2):175-81. https://doi.org/10.1097/01.id.0000058309.77613.87

Boyan BD, Bonewald LF, Paschalis EP, Lohmann CH, Rosser J, Cochran DL, Dean DD, Schwartz Z, Boskey AL. Osteoblast-mediated mineral deposition in culture is dependent on surface microtopography. Calcif Tissue Int. 2002 Dec;71(6):519-29. https://doi.org/10.1007/s00223-001-1114-y

Galli C, Passeri G, Ravanetti F, Elezi E, Pedrazzoni M, Macaluso GM. Rough surface topography enhances the activation of Wnt/β-catenin signaling in mesenchymal cells. J Biomed Mater Res A. 2010 Dec 1;95(3):682-90. https://doi.org/10.1002/jbm.a.32887

Javed F, Romanos GE. Role of implant diameter on long-term survival of dental implants placed in posterior maxilla: a systematic review. Clin Oral Investig. 2015 Jan;19(1):1-10. https://doi.org/10.1007/s00784-014-1333-z

Jimbo R, Albrektsson T. Long-term clinical success of minimally and moderately rough oral implants: a review of 71 studies with 5 years or more of follow-up. Implant Dent. 2015 Feb;24(1):62-9. https://doi.org/10.1097/ID.0000000000000205

Albrektsson T, Wennerberg A. On osseointegration in relation to implant surfaces. Clin Implant Dent Relat Res. 2019 Mar;21 Suppl 1:4-7. https://doi.org/10.1111/cid.12742

Amin Yavari S, Chai YC, Böttger AJ, Wauthle R, Schrooten J, Weinans H, Zadpoor AA. Effects of anodizing parameters and heat treatment on nanotopographical features, bioactivity, and cell culture response of additively manufactured porous titanium. Mater Sci Eng C Mater Biol Appl. 2015 Jun;51:132-8. https://doi.org/10.1016/j.msec.2015.02.050

Naves MM, Menezes HH, Magalhães D, Ferreira JA, Ribeiro SF, de Mello JD, Costa HL. Effect of macrogeometry on the surface topography of dental implants. Int J Oral Maxillofac Implants. 2015 Jul-Aug;30(4):789-99. https://doi.org/10.11607/jomi.3934

Messias A, Nicolau P, Guerra F. Titanium dental implants with different collar design and surface modifications: a systematic review on survival rates and marginal bone levels. Clin Oral Implants Res. 2019 Jan;30(1):20-48. https://doi.org/10.1111/clr.13389

Gehrke SA, Pérez-Diaz L, Mazón P, De Aza PN. Biomechanical effects of a new macrogeometry design of dental implants: an in vitro experimental analysis. J Func Biomater. 2019 Oct 25;10(4). https://doi.org/10.3390/jfb10040047

da Rosa de Souza PT, Manfro R, de Salles Santos FAO, Garcia GFF, Macedo NF, de Macedo BESF, Ignácio SA, Rosa EAR, de Souza EM, Azevedo-Alanis LR. Analysis of osseointegration of implants with macrogeometries with healing chambers: a randomized clinical trial. BMC Oral Health. 2024 Sep 19;24(1):1114. https://doi.org/10.1186/s12903-024-04857-8

Bonfante EA, Jimbo R, Witek L, Tovar N, Neiva R, Torroni A et al. Biomaterial and biomechanical considerations to prevent risks in implant therapy. Periodontol 2000. 2019 Oct;81(1):139-151. https://doi.org/10.1111/prd.12288

Sakoh J, Wahlmann U, Stender E, Nat R, Al-Nawas B, Wagner W. Primary stability of a conical implant and a hybrid, cylindric screw-type implant in vitro. Int J Oral Maxillofac Implants. 2006 Jul-Aug;21(4):560-6.

Heimes D, Becker P, Pabst A, Smeets R, Kraus A, Hartmann A, Sagheb K, Kämmerer PW. How does dental implant macrogeometry affect primary implant stability? A narrative review. Int J Implant Dent. 2023 Jul 5;9(1):20. https://doi.org/10.1186/s40729-023-00485-z

Silva GAF, Faot F, Possebon APDR, da Silva WJ, Del Bel Cury AA. Effect of macrogeometry and bone type on insertion torque, primary stability, surface topography damage and titanium release of dental implants during surgical insertion into artificial bone. J Mech Behav Biomed Mater. 2021 Jul;119:104515. https://doi.org/10.1016/j.jmbbm.2021.104515

Menezes HHM, Naves MM, Costa HL, Barbosa TP, Ferreira JA, Magalhães D et al. Effect of surgical installation of dental implants on surface topography and its influence on osteoblast proliferation. Int J Dent. 2018 Oct 17;2018:4089274. https://doi.org/10.1155/2018/4089274

Albrektsson T, Wennerberg A. Oral implant surfaces: Part 1–review focusing on topographic and chemical properties of different surfaces and in vivo responses to them. Int J Prosthodont. 2004 Sep-Oct;17(5):536-43.

Petrini M, Pierfelice TV, D’Amico E, Di Pietro N, Pandolfi A, D’Arcangelo C et al. Influence of nano, micro, and macro topography of dental implant surfaces on human gingival fibroblasts. Int J Mol Sci. 2021 Sep 13;22(18):9871. https://doi.org/10.3390/ijms22189871