Title	Implant Surface Coating Suggests a Positive Influence on Osseointegration
Clinical Question	In a patient seeking to get dental implants, is implant coating recommended compared to implants without coating, in order to achieve better osseointegration of the implant.
Clinical Bottom Line	Implant surface coating suggests a positive influence on osseointegration. For patients seeking dental implants an implant coating has been shown to promote osseointegration.
Best Evidence
PubMed ID Author / Year Patient Group Study type (level of evidence) 19663965 Junker/2009 Animal and human studies presenting bone-to-implant contact (BIC) percentage for implant surface modifications. In total, 51 reviews/publications were included in this analysis. Systematic Review of Animal and Human Studies Key results Found no definitive evidence of increased integration with implant coating, but did note a tendency for positive effects of coatings on bone-to-implant response. The review could not establish the coating as the sole reason for the positive correlation for bone-to-implant response, as other factors such as alterations in implant roughness were also considered in the study. The study also grouped together a wide variety of copings such as collagen and collagen mimetic peptides, collagen with chondroitin sulfate, collagen composite with CAP, bone morphogenetic proteins (BMPs), and non-BMP growth factors coated onto titanium implant surfaces. 22348981 Abtahi/2012 16 patients in need of two maxillary dental implants with similar bone quality at both sites. Randomized Split Mouth Trial Key results Each patient was treated with a thin bisphosphonate coated implant and uncoated implant. Fixation of the dental implant was evaluated by the implant stability quotient (ISQ) at a 6-month follow up. The ISQ increased 6.9 units more for the coated implants (p=0.0001; Cohen’s d=1.3). Also less bone resorption at the margin of the implant was noted in the coated implants at 2 month (p=0.012) and 6 month (p=0.012) recalls.
Evidence Search	(("dental implants"[MeSH Terms] OR ("dental"[All Fields] AND "implants"[All Fields]) OR "dental implants"[All Fields] OR ("dental"[All Fields] AND "implant"[All Fields]) OR "dental implant"[All Fields]) AND coating[All Fields]) AND ("2004/02/18"[PDat] : "2014/02/14"[PDat] AND "humans"[MeSH Terms])
Comments on The Evidence	Junker article is a systematic review taking into account many articles. The groups, treatment, follow-up, and types of coatings varied from study to study. There does not seem to be any competing interest from the personnel conducting this review. Abtahi article was a randomized double blind clinical trial. Full participation of the clients was achieved throughout spanning 6 months. The patients were all treated the same and there does not seem to be any recall bias or competing interest.
Applicability	Dental implant coating seems to be a good option for the stability and longevity of the implant. The positive effects on osseointegration may help with recovery speed and time intervals between appointments that may be a selling point for patients. Other factors may need to be considered such as cost, contraindications, and coating types.
Specialty	(Oral Medicine/Pathology/Radiology) (General Dentistry) (Periodontics)
Keywords	dentistry, implants, osseointegration, coating
ID#	2655
Date of submission	02/28/2014
E-mail	youngma@livemail.uthscsa.edu
Author	Michael Young
Co-author(s)
Co-author(s) e-mail
Faculty mentor	Concepcion Barboza, DDS
Faculty mentor e-mail	BarbozaArgue@uthscsa.edu
Basic Science Rationale (Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) None available
Comments and Evidence-Based Updates on the CAT (FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) None available