surface treatment of dental implants our vision. our company is iso9001 and iso13485 qualified for...
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SURFACE TREATMENT OFDENTAL IMPLANTS
OUR VISION
Our company is ISO9001 and ISO13485 qualified for research,
analysis and treatment of medical devices surfaces
Our treaments are based on 15 years of daily study and
investigation of materials surfaces through the most
advanced techniques
The peri-implant milieu is a kind of “primordial soup”, where signalling cues from surgery and cell interaction with the implant surface cooperate to
direct the outcome of the bone regeneration process
Surface treatment of dental implants is a “biological” act, based on the understanding of
mechanisms ofcell-implant interaction
The three pillars of surface treatment of dental implants from a biological point
of view
1. Control of surface topography to stimulate cell response along the osteogenic pathway
2. Control of surface chemistry to promote cell colonization
3. Control of biological contamination by adherent endotoxin to avoid interference with the natural inflammatory response
1. Control of surface topography to stimulate cell response along the osteogenic pathway
A huge scientific literature shows that details of surface topography affect cell behavior
It is nowadays recognized that topographic motifs smaller than cell size (micro- and nano-topography) stimulate osteogenic activity and promote peri-implant bone healing
The picture shows the
comparison between the
size of an osteoblast
(red) and surface
roughness, distance
between peaks is of the order of micrometer
or less
Present-day implant surfaces use microtopography as a language to communicate with cells from the host
tissue
Fluorescence images of osteoblasts on machined surfaces (left, 6 and 24 h) and on microrough surfaces (right, 6 and 24 h)
Surface topography affects cell morphology and behavior, this is the true meaning of roughening treatments
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Gene expression analysis shows that microrough surfaces increase expression of alkaline phosphatase and other osteogenic markers by adherent cells
microrough
machined4h 12h 24h 48h 72h
2. Control of surface chemistry to promote cell colonization
Surface topography is nice indeed, what about chemistry?
Area shown in the previous
slide
Dirt
Area shown in the first picture
Area shown in the first picture
The chemical contribution due to processing and packaging can affect cell response to topography
and it is an important variable
Is this a titanium implant?
Constant and satisfactory chemistry of dental implants surfaces requires:
Advanced approaches to cleaning
Continuous evaluation of production
XPS analysis
# C O Ti N Al Si Na Mg Ca Zn Cl F P surface1 76.5 18.2 1.4 2.1 0.6 0.2 0.6 0.3 0.1 m2 73.2 20.6 1.6 0.6 3.0 0.2 0.2 0.2 0.1 0.1 0.2 m3 66.5 24.6 4.7 1.0 0.8 0.2 1.8 0.3 m4 51.1 29.5 7.6 2.2 1.9 0.5 0.2 0.9 5.5 m5 54.9 30.5 8.5 2.9 0.5 0.2 1.0 0.3 0.2 0.1 m6 51.2 33.9 10.2 1.2 1.2 0.1 0.8 0.3 1.0 m7 46.7 37.1 11.4 0.7 1.9 0.4 1.5 0.2 0.1 m8 41.9 39.4 12.3 1.7 2.1 0.2 0.2 0.3 1.6 0.3 m9 35.5 40.8 12.7 1.8 7.0 0.9 0.5 0.2 0.5 m10 33.8 46.2 13.1 3.2 0.7 0.6 0.1 0.3 2.0 m11 39.5 42.9 13.9 1.3 1.5 0.1 0.7 m12 47.2 31.6 3.3 1.3 14.7 1.4 0.4 s13 17.9 51.7 18.3 0.7 6.3 2.4 0.5 2.0 s14 25.7 46.5 4.6 0.6 17.5 2.9 0.6 0.6 0.8 0.2 s15 40.6 39.3 6.5 4.7 0.9 0.8 1.5 1.5 1.3 0.2 0.9 1.8 s16 40.9 38.2 7.0 0.7 4.4 1.6 0.8 2.5 2.5 0.5 0.2 0.5 s17 46.9 34.0 9.3 0.7 3.3 0.6 2.4 1.8 0.5 0.5 s18 43.6 36.2 11.9 0.8 3.1 0.1 0.3 2.1 1.1 0.1 0.5 s19 35.4 44.4 14.4 1.6 0.9 0.6 0.6 0.2 0.9 1.0 s20 20.5 51.6 14.8 1.3 9.4 1.2 0.9 0.2 s21 33.9 46.8 14.9 1.1 0.7 1.3 0.3 0.1 0.1 0.8 s22 47.0 33.5 9.4 3.5 2.4 1.2 0.8 0.7 0.6 0.8 a23 42.9 38.2 12.5 2.8 1.4 0.8 0.6 0.7 a24 26.9 48.2 15.7 1.9 2.9 1.4 0.2 1.9 1.0 a25 36.2 43.5 15.8 1.0 2.5 0.2 0.1 0.2 0.3 a26 23.5 48.9 16.5 3.8 1.8 2.9 0.3 0.3 0.3 0.9 a27 23.2 43.9 17.0 2.2 1.6 2.9 0.5 0.3 8.4 a28 49.4 32.1 11.7 5.0 0.3 0.9 0.6 p29 33.4 42.9 15.8 4.1 1.0 0.2 0.7 0.9 0.7 p30 31.2 46.8 16.8 3.9 0.4 0.3 0.3 p31 33.5 43.4 17.1 2.3 1.8 0.9 0.9 0.1 p32 33.4 45.3 17.4 2.0 0.8 0.5 0.4 0.1 p33 29.4 48.4 18.1 2.2 0.5 0.1 0.2 0.6 0.3 p
Plasma cleaning
Definition of standards
COMPOSIZIONE SUPERFICIALE DI IMPIANTI IN COMMERCIOCOMPOSIZIONE SUPERFICIALE DI IMPIANTI IN COMMERCIO
C O Ti Altri comuni < 45 >40 >15 < 3
Definition of acceptance limits
3. Control of biological contamination by adherent endotoxin to avoid interference with the natural
inflammatory response
The need for complete removal of adherent endotoxin is more and more clear on the light of growing knowledge on its role in
bone-resorption pathologies
0
100
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700
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TNF-alfa IL-6 MCP-1 IL-1
fold
exp
ress
ion
0
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TNF-alfa IL-6 MCP-1 IL-1
fold
exp
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Implant handled bare hands
Control implant after endotoxin removal
cycle
Implant packaged at site
A
Implant packaged at site
B
These four implants are all alike, yet they promote a completely different inflammatory response
Advanced cleaning by
glow-discharge plasma,
controlled-environment
packaging, strict
adherence to “clean”
procedures, play a key-role
in the control of adherent
endotoxin (biological
cleanliness), the main player
in the immunological
response to implant
surfaces
0
20
40
60
80
100
120
140
160
180
200
fold
exp
ress
ion
This is the pro-inflammatory response to 22 different clinically available dental implants (IL-6
expression)
The composition of the “primordial soup” around these implants is very different and this affects the healing process, even if all of them are “titanium
implants”
Those in the red square are just “screws”, they are not
medical implant devices, designed and produced from
a biological standpoint and with the required knowledge
and care
These are the basis of surface treatment of dental implants at Nobil Bio Ricerche
For this reason, our production is continuously controlled in the light of the “biodesign” approach, that is of process and control
based on the cell-surface interaction
For all the relevant properties, acceptance criteria are set at the maximum quality levels
and continuously checked
All images and data have been obtained at Nobil Bio Ricerche labs
“Only after knowing the surface of things can one throw himself into the search for
what is underneath.
But the surface of things is endless"
Italo Calvino, Palomar