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SURFACE TREATMENT OF DENTAL IMPLANTS OUR VISION. Our company is ISO9001 and ISO13485 qualified for research, analysis and treatment of medical devices.

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Presentation on theme: "SURFACE TREATMENT OF DENTAL IMPLANTS OUR VISION. Our company is ISO9001 and ISO13485 qualified for research, analysis and treatment of medical devices."— Presentation transcript:

1 SURFACE TREATMENT OF DENTAL IMPLANTS OUR VISION

2 Our company is ISO9001 and ISO13485 qualified for research, analysis and treatment of medical devices surfaces

3 Our treaments are based on 15 years of daily study and investigation of materials surfaces through the most advanced techniques

4 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 of cell-implant interaction

5 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

6 1. Control of surface topography to stimulate cell response along the osteogenic pathway

7 A huge scientific literature shows that details of surface topography affect cell behavior

8 It is nowadays recognized that topographic motifs smaller than cell size (micro- and nano-topography) stimulate osteogenic activity and promote peri-implant bone healing

9 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

10 Present-day implant surfaces use microtopography as a language to communicate with cells from the host tissue

11 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 Alkaline phosphatase fold expression Gene expression analysis shows that microrough surfaces increase expression of alkaline phosphatase and other osteogenic markers by adherent cells microrough machined 4h12h24h48h72h

12 2. Control of surface chemistry to promote cell colonization

13 Surface topography is nice indeed, what about chemistry?

14 Area shown in the previous slide Dirt

15 Area shown in the first picture

16 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?

17 Constant and satisfactory chemistry of dental implants surfaces requires: Advanced approaches to cleaning Continuous evaluation of production XPS analysisPlasma cleaning Definition of standards COMPOSIZIONE SUPERFICIALE DI IMPIANTI IN COMMERCIO Definition of acceptance limits

18 3. Control of biological contamination by adherent endotoxin to avoid interference with the natural inflammatory response

19 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

20 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

21 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

22 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

23 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

24 “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


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