The Effect of Placement on Implant Surface Morphology

Dental implants have specific morphologies with carefully designed surface topographies for optimal performance at a cellular level. Previous in-vitro studies have shown these specifically designed micro-textured surfaces promote rapid osseointegration. Objectives: To investigate the damage/change to implants, which occurs as a result of placement in bone. Methods: Dental implants from two leading manufacturers, (Nobel Biocare, Sweden and Straumann, Switzerland) were investigated in-vitro. Six implants from each manufacturer were used, namely, NobelPerfect (NP) implants (Ti-Unite surface) and Straumann Solid Screw (SSS) implants (SLA surface). Osteotomies were performed and the implants placed according to the respective prescribed protocols into “Tecnoss” bone (dehydrated porcine rib) with an insertion torque of 45Ncm. Implants were removed atraumatically and washed in EDTA/Trypsin solution to remove osseous and organic debris. The implant surfaces were analysed, pre- and post- implantation, with micro-CT, optical and electron scanning (SEM) microscopy, to determine the extent of surface damage. Results: Optical microscopy enabled qualitative visual comparison of implant surface and morphology. Showing that both implant surface and to a lesser degree the implant body of NP implants had become distorted due to implantation. Only the implant surface was deformed on the SSS implants. Closer inspection using SEM confirmed significant changes to the surface texture of both types of implants after placement. Micro-CT analysis showed a reduction in surface area of 21% for NP and 9% for SSS implants respectively. Conclusions: Placement of implants under simulated clinical conditions can cause distortion of implants in addition to surface topography. Both implant systems surfaces were affected; but to a greater extent for NP implants. This brings in to question the validity of specific implant surface design. Moreover, the predicted success of, or speed of integration may be affected by the damage caused to implants during placement.