Cross-Sectional Evaluation of Hydroxyapatite-Coated Titanium Implants: Insights into Biocompatibility and Osseointegration
DOI:
https://doi.org/10.36283/ziun-pjmd14-2/048Keywords:
Hydroxyapatites, Titanium, Implant, Osseointegration, Biocompatibility, Dental Implant StabilityAbstract
Background: The application of hydroxyapatite (HA) coatings represents a powerful method for improving the biorientation of titanium dental implants and their compatibility with human tissue. The research examined the consequences of applying HA coatings on dental implant integration while investigating bone tissue response in the nearby area.
Methods: In this cross-sectional collaborative study conducted mainly at Baqai Medical University, Lahore Medical and Dental College and Muhammad Islam Dental College, eighty patients (BMU-EC/006-22) (average age 55.3 ± 8.7 years) participated in the assessment during the period from August 2022 to December 2023 based on a purposive sampling technique. The evaluation of implant stability, together with peri-implant bone density and inflammatory response markers, constituted the clinical measurement criteria. Professionals used both patient evaluations and imaging data to evaluate the efficiency of osseointegration. The analysis of data occurred through SPSS version 20 using one way ANOVA with p-value<0.05, statistically significant. Research findings for HA-coated versus uncoated implants derived from independent t-tests for continuous variables and chi-square tests for categorical data.
Result: The study outcomes revealed that implants coated with HA exhibited better bone attachment to implant surfaces, enhanced implant stability (p = 0.012), and decreased inflammation markers (p = 0.018). Under histological examination, there was improved contact between bone tissue and the implant surface, which proves that HA contributes to quick osseointegration.
Conclusion: The implant recipients with HA coatings experienced fewer complications and better outcomes in terms of functionality.
References
Fernandes PRE, Otero AIP, Fernandes JCH, Nassani LM, Castilho RM, de Oliveira Fernandes GV. Clinical Performance Comparing Titanium and Titanium-Zirconium or Zirconia Dental Implants: A Systematic Review of Randomized Controlled Trials. Dent J (Basel). 2022 May;10(5):83. doi: 10.3390/dj10050083.
Smeets R, Stadlinger B, Schwarz F, Beck-Broichsitter B, Jung O, Precht C, et al. Impact of Dental Implant Surface Modifications on Osseointegration. Biomed Res Int. 2016 Apr;2016:6285620. doi: 10.1155/2016/6285620.
Neto JVC, Teixeira ABV, Cândido Dos Reis A. Hydroxyapatite coatings versus osseointegration in dental implants: A systematic review. J Prosthet Dent. 2023 Oct;3913(23):631-635. doi: 10.1016/j.prosdent.2023.09.019.
Satou R, Iwasaki M, Kamijo H, Sugihara N. Improved Enamel Acid Resistance Using Biocompatible Nano-Hydroxyapatite Coating Method. Materials (Basel). 2022 Oct;15(20):7171. doi: 10.3390/ma15207171.
Santos AFP, da Silva RC, Hadad H, de Jesus LK, Pereira-Silva M, Nímia HH, et al. Early Peri-Implant Bone Healing on Laser-Modified Surfaces with and without Hydroxyapatite Coating: An In Vivo Study. Biology (Basel). 2024 Jul;13(7):533. doi: 10.3390/biology13070533.
Safi IN, Hussein BMA, Aljudy HJ, Tukmachi MS. Effects of Long Durations of RF-Magnetron Sputtering Deposition of Hydroxyapatite on Titanium Dental Implants. Eur J Dent. 2021 Jul;15(3):440-447. doi: 10.1055/s-0040-1721314.
Latimer JM, Gharpure AS, Kahng HJ, Aljofi FE, Daubert DM. Interproximal open contacts between implant restorations and adjacent natural teeth as a risk-indicator for peri-implant disease—A cross-sectional study. Clin Oral Implants Res. 2021 May;32(5):598-607. doi: 10.1111/clr.13730.
Imran E, Mei ML, Li KC, Ratnayake J, Ekambaram M, Cooper PR. Dental Applications of Ion-Substituted Hydroxyapatite: A Review of the Literature. Dent J (Basel). 2024 Oct;12(10):304. doi: 10.3390/dj12100304.
Kim J, Kang IG, Cheon KH, Lee S, Park S, Kim HE, et al. Stable sol-gel hydroxyapatite coating on zirconia dental implant for improved osseointegration. J Mater Sci Mater Med. 2021 Jul;32(7):81. doi: 10.1007/s10856-021-06550-6.
Yurttutan E, Dereci Ö, Karagöz MA. Biomechanical and Histologic Evaluation of Osseointegration of Titanium Dental Implants Modified by Various Combinations of Sandblasting, Acid-Etching, Hydroxyapatite, and Hyaluronic Acid Coating Techniques. Int J Oral Maxillofac Implants. 2023 May-Jun;38(3):583-590. doi: 10.11607/jomi.9935.
Batool F, Özçelik H, Stutz C, Gegout PY, Benkirane-Jessel N, Petit C, et al. Modulation of immune-inflammatory responses through surface modifications of biomaterials to promote bone healing and regeneration. J Tissue Eng. 2021 Sep;12(1):414-428. doi: 10.1177/20417314211041428.
Accioni F, Vázquez J, Merinero M, Begines B, Alcudia A. Latest Trends in Surface Modification for Dental Implantology: Innovative Developments and Analytical Applications. Pharmaceutics. 2022 Feb;14(2):455. doi: 10.3390/pharmaceutics14020455.
Bandyopadhyay A, Mitra I, Goodman SB, Kumar M, Bose S. Improving Biocompatibility for Next Generation of Metallic Implants. Prog Mater Sci. 2023 Jan;133(1):101053. doi: 10.1016/j.pmatsci.2022.101053.
Zieliński R, Puszkarz AK, Piętka T, Sowiński J, Sadowska-Sowińska M, Kołkowska A, et al. Comparative Evaluation of Bone-Implant Contact in Various Surface-Treated Dental Implants Using High-Resolution Micro-CT in Rabbits' Bone. Materials (Basel). 2024 Nov;17(22):5396. doi: 10.3390/ma17225396.
Komatsu K, Matsuura T, Cheng J, Kido D, Park W, Ogawa T. Nanofeatured surfaces in dental implants: contemporary insights and impending challenges. Int J Implant Dent. 2024;10(1):34. doi: 10.1186/s40729-024-00550-1.
Almulhim KS, Syed MR, Alqahtani N, Alamoudi M, Khan M, Ahmed SZ, et al. Bioactive Inorganic Materials for Dental Applications: A Narrative Review. Materials (Basel). 2022 Oct;15(19):6864. doi: 10.3390/ma15196864.
Chatzopoulos GS, Wolff LF. Dental implant failure and factors associated with treatment outcome: A retrospective study. J Stomatol Oral Maxillofac Surg. 2023 Apr;124(2):101314. doi: 10.1016/j.jormas.2022.10.013.
Jafari B, Katoozian HR, Tahani M, Ashjaee N. A comparative study of bone remodeling around hydroxyapatite-coated and novel radial functionally graded dental implants using finite element simulation. Med Eng Phys. 2022 Oct;102:103775. doi: 10.1016/j.medengphy.2022.103775.
Borcherding K, Schmidmaier G, Hofmann GO, Wildemann B. The rationale behind implant coatings to promote osteointegration, bone healing or regeneration. Injury. 2021 Jun;52(2):S106-S111. doi: 10.1016/j.injury.2020.11.050.
Van den Borre CE, Zigterman BGR, Mommaerts MY, Braem A. How surface coatings on titanium implants affect keratinized tissue: A systematic review. J Biomed Mater Res B Appl Biomater. 2022 Jul;110(7):1713-1723. doi: 10.1002/jbm.b.35025.
German IJ, Barbalho SM, Andreo JC, Zutin TL, Laurindo LF, Rodrigues VD, et al. Exploring the Impact of Catechins on Bone Metabolism: A Comprehensive Review of Current Research and Future Directions. Metabolites. 2024 Oct;14(10):560. doi: 10.3390/metabo14100560.
Gnanajothi J, Rajasekar A. Inflammatory Status of Patients with Dental Implants of Different Microgeometry using ELISA: A Prospective Clinical Study. J Int Oral Health. 2024 Jun;16(6):472-478. doi: 10.4103/jioh.jioh_47_24.
Ko YC, Lee D, Koo KT, Seol YJ, Lee YM, Lee J. A randomized controlled trial of immediate implant placement comparing hydroxyapatite nano-coated and uncoated sandblasted/acid-etched implants using a digital surgical guide. Int J Implant Dent. 2024;10(1):29. doi: 10.1186/s40729-024-00549-8.
Chamrad J, Marcián P, Cizek J. Beneficial osseointegration effect of hydroxyapatite coating on cranial implant - FEM investigation. PLoS One. 2021 Jul;16(7):e0254837. doi: 10.1371/journal.pone.0254837.
Kushram P, Majumdar U, Bose S. Hydroxyapatite-coated titanium with curcumin and epigallocatechin gallate for orthopedic and dental applications. Biomater Adv. 2023 Jul;155(1):213667. doi: 10.1016/j.bioadv.2023.213667.

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