Have coated dental implants fallen out of favor?

I haven't placed any HA coated implants since my residency in the 90's. They worked, but once the HA coating became exposed, loss of implant was rapid. They have fallen out of favor as evidenced by what the implant companies are producing.

There have been many marketing claims regarding surface treatments and coatings. The marketplace seems to favor mircro rough surface treatments, the most popular being sandblasted, acid etched (SLA), which Implant Direct does not offer. In their product line, the HA coated implants were "rough", but the coating is very thick. Off the top of my head, the only significant HA variation is from Hiossen/Osstem NH line, which has a 10 micron micro crystalline HA coating that resorbs rapidly, but allows for excellent capillary effect and shortened healing times. The major advantage I see with these proprietary surface coatings and treatments is a decreased healing time prior to loading. For example, in a Type 2 quality healed ridge, I am comfortable taking final impressions in 6-8 weeks depending on the location and purpose of the restoration, and fully loading the implant a few weeks later. With RBM, I would wait 4 full months prior to impressions, and 10-12 weeks for SLA. Hope this helps.

HA,and TPS , along with brushite and most other Coatings have gone out of favor due to the very difficult task of keeping them bacteria free and once they are polluted they become hard to manage. This is also true for titanium surface but it seems that it's more manageable and titanium has better properties in this area. In the other direction hemoderivates are also used but they have the problem of every hemoderivate, they last what they last and so not really considered coatings.

When I and my wife needed implants I selected HA coated Legacy implants because it is proven to provide faster and stronger bone attachment. The VA study of the early 1990’s proved that HA provided significantly better results compared to the relatively smooth acid etched surface. This lead to all Core-Cent implants being blasted with HA crystals which are solvable, Russia’s creating their surface called SBM, also used by Zimmer, BH and many others. That, in combination with my development of the tapered Screw-Vent with its soft bone surgical protocol of preparing the socket with an undersized step-drill (now incorporated in Straumann’s BLX system) leveled the playing field between coated and uncounted implants. Whether HA coated surfaces provide clinically significant better results over the SBM blasted surface is hard to prove given the very high success rates with the Legacy implants but in poor quality bone with poor initial stability, I believe HA would make a difference . As shown in this video, placing a Legacy2 HA implant in the Maxillary 2nd bicuspid by August de Olliviera, on a relative of mine, he achieved greater than 60Ncm of initial torque, obviating the need for the HA. On my wife’s immediate placement lower first molar where August nearly had 3mm of bone engagement ,, the HA Legacy, surrounded mainly by graft material, could make the difference between success and failure. Implant Direct is now run by Nobel who seems more concerned about selling its high priced implants than selling Implant Direct’s better implants so dropping HA is just another way of trying to reduce competition with its TiUnite surfaced implants.

I believe Straumann still sells an SLA implant

I agree with Niznick, HA is the way to go. I have placed thousands of HA coated implants and I will keep placing them over any other surfaces. I am the president of Quantum implant and we use to have different surface treatments for implants. HA, RBM and others. We are only providing HA at this time due to the high success rate and faster integration. There is a lot of misinformation and marketing hip in dentistry

Its true HA coated implants needs shorter time for osseointigration than pure titanium surface.