Dr. VR asks:
I would like to learn more about the effect of various surface treatments on the implant fixture. There are over one hundred companies producing implants and there are many different kinds of surface treatments. I would like to be able to compare the various surface treatments to determine which are the most effective. Can you recommend some excellent references in the peer reviewed literature? More importantly, what are your experiences in real world dentistry? I would like to get some feedback from those of you who have had very positive or negative experiences.
Moderately roughened implants have the longest track record. Astra’s fluoride-modified and Straumann’s sla-active show some improvement upon the more conventional blasted titanium which may allow you to load them a bit earlier. From what I’ve read, Nobel’s tiunite is lacking. A moderately rough, tapered, bone level implant with a medialized abutment is what I prefer. Astra’s and Straumann’s chemical modifications are nice but not worth the extra $$ to me. The majority of my patients would rather wait 1 more month to load and save a few hundred. Until they introduce implants with BMP or similar that stimulate new bone growth, it will be hard to beat a threaded, moderately roughened titanium screw, imo.
Dr VR
You may want to email the Intra-lock company for references and literature on their “Ossean” surface.
However, most reputable companies today have very adequate treatment of their implant surfaces.