ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Dental Implants Coated in Hydroxyapatite and Phosphate Materials Show the Potential to Achieve Greater Osseointegration and Increased Mechanical Stability Compared to the Uncoated Titanium Dental Implant
Clinical Question In the adult patient, will implants that have been coated in hydroxyapatite and phosphate materials achieve greater osseointegration than the uncoated conventional titanium implant?
Clinical Bottom Line Implants that have been coated in hydroxyapatite and phosphate materials show considerably better osseointegration and increased mechanical stability compared to the uncoated conventional implant. Hydroxyapatite and phosphate are very biologically compatible in bone, but the research has shown that there are other materials that show better integration.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 24331565Lee/201424 implants placed in the tibias of rabbitsLaboratory Study
Key resultsIn this study, the implants coated in collagen plus hydroxyapatite showed a significantly greater results in peri-implant bone formation and bone-to-implant contact compared to uncoated implants (P=0.003 and P<0 .001 respectively).
#2) 25588174Xuereb/201540 studies on implant coatings Systematic Review
Key resultsSeveral dental implant coatings were evaluated in this study, including hydroxyapatite, bisphosphonates, carbon, and new innovative bioactive glasses and bioactive ceramics. The results showed that the hydroxyapatite coatings have the most long-term clinical results and are the most commonly used. “Novel materials such as bioglass and carbon coatings are showing promising results.” The bioactive glass coatings are still being studied for long-term clinical success, while the hydroxyapatite-coated implants have continued to show acceptable osseointegration and biocompatible properties.
Evidence Search “Dental Implants” [Mesh} and “Osseo-integration”[All terms] and “Calcium hydroxyapatite” [all terms]
Comments on
The Evidence
Validity: In the study by Lee, all groups were similar at start for each of the comparison to the intervention. The investigators followed strict guidelines of coating each implant, confirming the coating using SEM and x-ray diffraction, and then placing them into rabbit tibias. A limitation of an animal study is the uncertainty in generalizing the results to a human population, ie, how implantation in the alveolar bone of humans would affect the results. Moreover, the study only used 12 rabbits and 24 implants (n=6 for each coating type), making it a very small study size. As for the systematic review by Xuereb of various implant coating materials and techniques, close to 300 articles were screened for inclusion and the 40 included studies that addressed coating types were compared for their long-term clinical success. The large amount of articles taken into consideration for the study increases its validity. Perspective: The results provided from these two studies give a good idea of how to better understand the effectiveness of coated dental implants, but there is still a need for further study to increase understanding of the various materials. This is especially important for products that are currently being made and tested in the labs.
Applicability Implants with coatings have been shown to provide better success and acceptability. This treatment is commonly used in the dental setting, and these results only show that improvements continue to be made, with greater results for clinical success.
Specialty/Discipline (General Dentistry) (Oral Surgery) (Periodontics)
Keywords coated dental implants, calcium phosphate, hydroxyapatite
ID# 2902
Date of submission: 04/13/2015spacer
E-mail RiceMC@livemail.uthscsa.edu
Author Mason Rice
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Norma Olvera, DDS, MS
Faculty mentor/Co-author e-mail OlveraN@UTHSCSA.edu
Basic Science Rationale
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