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1. Surface Treatment Of
Implants
Piyali bhattacharya
2nd Year PGT,
Prosthodontics and crown & Bridge,
HIDSAR

2. Introduction
• The implant/tissue interface is influenced by numerous
factors, including surface chemistry and surface
topography of the foreign material.
• Surface modifications have been applied to metallic
biomaterials on macroscopic, microscopic and nano level
in order to improve mechanical, chemical, and physical
properties such as wear resistance, corrosion resistance,
biocompatibility and surface energy.
• On the macroscopic level surface roughness influences
the mechanical properties of the titanium/bone interface,
through mechanical interlocking of the interface.

3. • Microrough surfaces enhances the mechanical
retention between two surfaces, by sand- blasting,
acid etching shot peening, or laser peening method.
• The interfacial interaction between recipient tissues
and implanted material are limited to the surface
layer of the implant and a few nanometers into the
living tissue
• For discussion purposes, the biomaterial
characteristics can be separated into categories
associated with either (1) surface or (2) bulk
properties

6. Surface Characterization and Tissue
Interaction
• Metal and Alloy Surfaces
1. TITANIUM:
Standard grades of alpha (unalloyed) titanium and alpha-
beta and beta-base alloys of titanium exist with an oxide
surface at room temperature , A formation of a thin oxide
exists via dissociation of and reactions with oxygen or
other mechanisms such as oxygen or metal ion diffusion
from and to the metallic surface, especially for titanium

7. • the oxide is primarily TiO2, This thin layer of
amorphous oxide will rapidly reform if removed
mechanically. Low-temperature thermal oxides are
relatively homogeneous and dense; with increasing
temperatures, they become more heterogeneous and
more likely to exhibit porosity as scale formations, and
some have glasslike surface oxide conditions
(semicrystalline)*
*Radegran G, Lausmaa J, Rolander U, et al: Preparation of ultra-thin oxide windows on
titanium for TEM analysis, J Electron Miscrosc Tech 19:99–106, 1991.

8. • Tissue interaction
Oxide modification during in vivo exposure has been
shown to result in increased titanium oxide layer
thickness of up to 200 nm
• Whereas the highest oxide growth area corresponded
to a bone marrow site, the lowest growth was
associated with titanium in contact with cortical
regions of bone. Increased levels of calcium and
phosphorus were found in the oxide surface layers and
seemed to indicate an active exchange of ions at the
interface. Hydrogen peroxide environmental conditions
have been shown to interact with Ti and form a
complex gel*
*Tengvall P, Elwing H, Sjoqvist L, et al: Interaction between hydrogen peroxide and titanium:
a possible role in the biocompatibility of titanium, Biomaterials 10:118–120, 1989.

9. • “Titanium gel conditions” are credited with attractive in vitro
properties such as low apparent toxicity, inflammation, bone
modeling, and bactericidal characteristics.*
• Other elements interacting with the surface layer of several
implanted materials are calcium and phosphorus.
• In vitro studies showed that both titanium or titanium alloy
were released in measurable quantities of the substrate
elements at the surface Ion release corresponds to an oxide
layer thickness growth with inclusions of calcium, phosphorus,
and sulfur in particular.
*Tengvall P, Elwing H, Sjoqvist L, et al: Interaction between hydrogen peroxide and titanium:
a possible role in the biocompatibility of titanium, Biomaterials 10:118–120, 1989.

10. • This is especially a concern for larger orthopedic
or porous implants, in which such ion release
may be a part of the origin of implant failure and
allergic reactions and has even been proposed to
be a local or systemic reason for the formation of
tumors.**
**Bruneel N, Helsen JA: In vitro stimulation of biocompatibility of Ti-6Al-4V, J Biomed
Mater Res 22:203–214, 1988.

11. 2. COBALT AND IRON ALLOYS:
• The alloys of cobalt (Vitallium) and iron exhibit oxides
of chromium (primarily Cr2O3 with some suboxides)
under normal implant surface-finishing conditions
after acid or electrochemical passivation. These
chromium oxides result in a significant reduction in
chemical activity and environmental ion transfers.
Under normal conditions of acid passivation, these
chromium oxides are relatively thin (nanometer
dimensions). the titanium, cobalt, and iron metallic
systems depend on the surface reaction zones with
oxygen (oxides) for chemical and biochemical
inertness.

12. • Along the surfaces, the chromium oxide covers
the matrix phase (metallic regions), the carbides
stand as secondary components (usually as
mounds above the surface) at the microscopic
level.
• Thus tissue-to oxide and tissue-to–metallic
carbide zones could be used to describe tissue
integration of cobalt alloy.
• The iron-based alloy chromium oxide and
substrate are more susceptible to environmental
breakdown compared with cobalt- and titanium-
based biomaterials.

13. • In general, if stainless steel implant surfaces are
mechanically altered during implantation or if
the construct introduces an interface that is
subjected to biomechanical fretting, then the
iron alloy will biodegrade in vivo, and the fatigue
strength of surgical stainless steel can be
significantly decreased in a corrosive
environment.*
*Morita M, Hayashi H, Sasada T, et al: The corrosion fatigue properties of surgical implants in a
living body. In de Putter C, et al, editors: Implant materials in biofunction (vol 8), Amsterdam,
1988, Elsevier.

14. • Ceramics
Aluminum oxide ceramics are fully oxide materials
(bulk and surface), They occur as polycrystalline
and single crystalline form
These forms have introduced very different
surface roughness values for the same material
substrate plus bulk properties in which ion transfer
and electrochemical phenomena are minimal
influences.

15. • Ceramic coatings (e.g., Al2O3) have been shown to
enhance the corrosion resistance and
biocompatibility of metal implants, particularly
surgical stainless steel and Ni-Cr and Co-Cr alloys*
• Studies in orthopedics caution that the Al2O3
coating may cause a demineralization phenomenon
caused by a high local concentration of substrate
ions in the presence of metabolic bone disease.**
*Sella C, Martin JC, Lecoeur J, et al: Biocompatibility and corrosion resistance in biological
media of hard ceramic coatings sputter deposited on metal implants, Mater Sci Eng A Struct
Mater 139:49–57, 1991.
**Toni A, Lewis CG, Sudanese A, et al: Bone demineralization induced by cementless
alumina coated femoral stems, J Arthrop 9:435–441, 1994.

16. • Hydroxyapatite
CaPO4–based ceramic or ceramic-like coatings have been
added to titanium and cobalt alloy substrates to enhance
tissue integration and biocompatibility.
These coatings are applied by plasma spraying small-size
particles of crystalline HA ceramic powders.
Machined implants exhibit an irregular surface with
grooves, ridges, and pits including a nanometer-thickness
scale.
Surface roughening by particulate blasting can be
achieved by different media-
i) Sandblasting provides irregular surfacing with less than
10-mm scales and a potential for impurity inclusions.

17. ii) Titanium implants may be etched with a solution of
nitric and hydrofluoric acids to chemically alter the surface
and eliminate some types of contaminant products .The
acids very rapidly attack metals other than titanium,
*Supporters of this technique argue that implants treated
by sandblasting and acid etch provide superior
radiographic bone densities along implant interfaces
compared with titanium plasma– sprayed surfaces. **But it
has also been argued to have possible risk of associated
osteolysis caused by foreign debris
*Cochran DL, Nummikoski PV, Higginbottom FL, et al: Evaluation of an endosseous titanium
implant with a sandblasted and acid etched surface in the canine mandible: radiographic
results, Clin Oral Implants Res 7:240–252, 1996.
**Clarke A: Particulate debris from medical implants. In St. John KR, editor: ASTM STP 1144,
Philadelphia, 1992, American Society for Testing and Materials.

18. iii) Another technique of creating surface roughness
is by restorable blast media (RBM). This technique
provides a comparable roughness to an alumina grit
blast finish, which can be a rougher surface than the
machined, glass-beaded, or acid-etched surfaces.
Examples of blast particulate include hydroxyapatite,
beta-tricalcium phosphates, and similar calcium
phosphate ceramics. These particulates are more
biocompatible than alumina and easier to remove
from the roughened surface.

19. • Porous and Featured Coatings-
a) Titanium Plasma Sprayed
b) Hydroxyapatite Coating
c) Microchannels
a) Titanium Plasma Sprayed
• Porous or rough titanium surfaces have been
fabricated by plasma spraying a powder form of
molten droplets at high temperatures. At
temperatures in the order of 15,000° C, an argon
plasma is associated with a nozzle to provide very
high velocity 600 m/sec partially molten particles of
titanium powder (0.05- to 0.1-mm diameter)

20. projected onto a metal or alloy substrate.
The plasma-sprayed layer after solidification (fusion)
is often provided with a 0.04- to 0.05-mm thickness.
When examined microscopically, the coatings show
round or irregular pores that can be connected to
each other.
• Schroeder et al. concluded that the rough and
porous surfaces showed a three-dimensional
interconnected configuration likely to achieve
bone–implant attachment for stable anchorage.

21. • proponents of porous surface preparations
reported that there have been results showing
faster initial healing compared with non-coated
porous titanium implants and that porosity allows
bone formation within the porosities even in the
presence of some micro-movement during the
healing phase,
• Such surfaces were also reported to allow the
successful placement of shorter-length implants
compared with non-coated implants

22. b) Hydroxyapatite Coating
• Hydroxyapatite coating by plasma spraying was
brought to the dental profession by deGroot.
• HA coating lower the corrosion rate of the same
substrate alloys
• The bone adjacent to the implant has been reported
to be better organized than with other implant
materials and with a higher degree of
mineralization.*
• In addition, numerous histologic studies have
documented the greater surface area of bone
apposition to the implant compared with uncoated
implants
* Thomas KA, Jay JF, Cook SD, et al: The effect of surface macrotexture and hydroxylapatite
coating on the mechanical strengths and histologic profiles of titanium implant materials,
J Biomed Mater Res 21:1395–1414, 1987.

23. • Implants of solid sintered HA have been shown to be
susceptible to fatigue failure. This situation can be
altered by the use of a CPC coating along metallic
substrates.
• In addition, the deposited CPC may be partially
resorbed through remodeling of the osseous
interface. *It is therefore wise to provide a
biomechanically sound substructure design that is
able to function under load-bearing conditions to
compensate for the potential loss of the CPC coating
over years.
*Geesink RGT, deGroot K, Klein CPAT: Bonding of bone to apatite coated implants, J Bone
Joint Surg 70B:17–22, 1988.

24. • One advantage of CPC coatings is that they can act
as a protective shield to reduce potential slow ion
release from the Ti-6Al-4V substrate.*
• In addition, the inter-diffusion between titanium
and calcium (and phosphorus and other elements)
may enhance the coating substrate bond by adding
a chemical component to the mechanical bond.
*Ducheyne P, Healy KE: The effect of plasma sprayed calcium phosphate ceramic coatings
on the metal ion release from porous titanium and cobalt chrome alloys, J Biomed Mater
Res 22:1127–1163, 1988.

25. c) Microchannels
• Microchannel promotes a connective tissue
interface that is more robust and may be able to
resist oral biological stresses, such as bacterial
invasion
• Nevins et al. report human histology that shows
connective tissue attachment to the microchannel
surface.* Furthermore, the fibers in this region
appeared to have a functional orientation
*Nevins M, Nevins ML, Camelo M, et al: Human histologic evidence of a connective tissue
attachment to a dental implant, Int J Periodontics Restorative Dent 28(2):111–121, 2008.

26. • Evidence suggests that this connective tissue
attachment may somehow insulate or protect the
underlying bone, leading to stable long term
crestal bone levels.

27. References
1. Radegran G, Lausmaa J, Rolander U, et al: Preparation of
ultra-thin oxide windows on titanium for TEM analysis, J
Electron Miscrosc Tech 19:99–106, 1991.
2. Bruneel N, Helsen JA: In vitro stimulation of biocompatibility
of Ti-6Al-4V, J Biomed Mater Res 22:203–214, 1988.
3. Morita M, Hayashi H, Sasada T, et al: The corrosion fatigue
properties of surgical implants in a living body. In de Putter C,
et al, editors: Implant materials in biofunction (vol 8),
Amsterdam, 1988, Elsevier.
4. Sella C, Martin JC, Lecoeur J, et al: Biocompatibility and
corrosion resistance in biological media of hard ceramic
coatings sputter deposited on metal implants, Mater Sci Eng
A Struct Mater 139:49–57, 1991.

28. 5. Toni A, Lewis CG, Sudanese A, et al: Bone demineralization
induced by cementless alumina coated femoral stems, J
Arthrop 9:435–441, 1994.
6. Thomas KA, Jay JF, Cook SD, et al: The effect of surface
macrotexture and hydroxylapatite coating on the
mechanical strengths and histologic profiles of titanium
implant materials, J Biomed Mater Res 21:1395–1414, 1987.
6. Geesink RGT, deGroot K, Klein CPAT: Bonding of bone to
apatite coated implants, J Bone Joint Surg 70B:17–22, 1988.
7. Nevins M, Nevins ML, Camelo M, et al: Human histologic
evidence of a connective tissue attachment to a dental
implant, Int J Periodontics Restorative Dent 28(2):111–121,
2008.