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Dental Implant Fixture Surface Treatment: How Durable Is It?

posted in Surgical Placement of Dental Implants, Surface Coating, advice

« All-On-4 Implants System: Longevity and Durability? | CAD/CAM Implant Restorations In-House: Should I Head in this Direction? »

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Anon. asks:
How durable is the titanium oxide layer on the surface of the implant fixture? If this surface comes into contact with a metallic instrument or glove will the surface be removed or contaminated to the point where it will be useless for osseointegration? If this occurs during implant placement should we not place the implant fixture and use a new one instead? Can anything be done to restore the titanium oxide layer? Should the implant fixture in cases like this just be discarded? I am also concerned if I use a surgical guide stent with metal copings, if I contact the coping surface when I am inserting the implant fixture? What guidance do you have for situations like this? Thanks.

9 Responses to “ Dental Implant Fixture Surface Treatment: How Durable Is It? ”

• Dennis Nimchuk September 27th, 2009

  
  

  It is a good idea to handle the surface of the implant as little as possible if for no other reason than to minimize organism or foreign body contamination. However, if the titanium oxide surface should become scratched it will reoxidize within nanoseconds with no loss of integration potential. Contact with other titanium instruments or surgical stainless steel instruments will not harm the implant integration surface unless the threads are damaged or deformed making insertion placement difficult.

• David Levitt September 30th, 2009

  
  

  In theory a stainless steel instrument that comes in contact with titanium oxide will cause a small area of corrosion due to the ionic properties of the two dissimilar metals. In practice it doesn’t seem to matter. Some implant companies thicken the titanium oxide layer by emersing the implant in Nitric acid. It would be impractical for a practitioner to duplicate that maneuver.

• A.Romano dr.med.dr.dent Italy October 5th, 2009

  
  

  in my practice i put the implants of every kind of form, lenght, measures ( i use only one piece implants) in a steinless steel box .

  i treat these implants with 40% H202, ECC. ECC. BUT i never seen any incompatibility with their oseeo-integration and this along 25 years.

  any other speculation on contamination of titanium implant is a nonsence except organic contamination.

• Dr.med. Dr. dent Alessandro Romano Italy October 11th, 2009

  
  

  my name is no more inserted

• Dr . oberai October 19th, 2009

  
  

  what is recommended in case of implant failure after
  a single stage sinus lift procedure.

• Dr.Islam November 18th, 2009

  
  

  I want to know if the surface treatment of implant is lost if you remove the implant and re insert it immediately (may be to increase the lenght/diameter of osteotomy site) ?? i guess it should be lost.anyone could share his experience

• Roland Balan November 18th, 2009

  
  

  Once you insert it it reacts with the tissue involved.
  It will not react a second time if you reinsert it.
  In the time inbetween the first and second insertion of the implant- the blody smear layer will react with air (oxidation) and might get contamined.

  Theoretically thinking- a storing in a anticoagulant substance might be of advantage. Reimplanting the implant micro-bleeding is induced which on its own is screeming for the thrombocytes to come. (PRP?/
  Why using centrifuges for contamination ?)
  Then it would make sense to keep them in EDTA or Citrat
  short before insertion- no matter if the first or second.
  1)The inhibited bleeding will stop and coagulate lateron, after having got in deeper contact with the titanium surface. 2) the blood clot on the surface will not get disrupted while enosal tension desolves in the first minutes/hours/day after insertion when tension around implant begins to disolve.
  As the implant closes the osteotomy- no harm should evolve.

• Dr.Islam November 20th, 2009

  
  

  thanks Roland
  is there a chance the implant could integrate? its better to replace it?

• Roland Balan November 21st, 2009

  
  

  I would not replace it without indication to do so.
  Almoast all implants get contamined, so does the implant site while we are changing the drills if our assistancy fails to pay attention or the patient swallows although told not to do so.
  There is some intentional contamination too- Think about the useres who intentinaly applicate terracotil paste on the screw threads. They do it because it reduces friction while inserting the implant into bone-perhaps also because they know it gets contamined anyway during procedure- preventively.

  Bacterial attack on bone is initated and propagated by softtissue reaction. If bacteria would eat bone, we would never find bone neither in nature nor in caves.
  Bacteria is seen on the locus minoris resistentie “eating”(dissolving) the organic bony tissue secondary - first deminaralistion is induced by a inflamatory process of soft tissue.

  Contact with a metallic instrument or glove is not that decisive but shall be avoided.

  What we know is that soft tissue overgrows defects first. We don`t know if the bone has firmly healed up by that time. Therefore some times we have to deal with dolor post extraction´and to do a revision.
  On the other hand we know the phenomeneon of spontanuos remission of tuberculosis (by calcification) and its akute outbreak in case of a pneuomonia.

  In fact we insert fixtures in formal ill sites. And by insertion we at least induce a traumatic inflamatory reaction.

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