Hassan Maghaireh

Engineering the Bone-Implant Interface

The world of osseointegration has moved forward as a courtesy of the recent technological revolutionwhich has presented itself in many forms, one of which is the introduction of new implant geometries and surfaceswhich is changing the surgical protocols, making everything easier, faster, andmore predictable. In fact, new implant macrotopographies have been introduced aiming to allow clinicians to obtain better and more predictable primary stability, therefore using dental implants as a solution to more challenging cases (such as areas of poor bone quality and/or in fresh postextraction sockets), with the possibility of anticipating nonconventional loading scenarios of the prosthetic superstructure, with the aim to provide positive patients outcome based on obtaining predictable shortand long-term results. Immediate placement of dental implants in fresh extraction sockets is usually highly appreciated protocol by patients, as it can provide satisfactory restorations at fraction of trauma, time, and cost. Similarly, the possibility of speeding up fitting the prosthetic superstructure is appreciated by patients, because it reduces treatment time and the related costs; in addition, it allows patients to avoid the discomfort and embarrassment of having to use provisional removable dentures during the healing period, with functional and aesthetic benefits. In order to accelerate the bone healing processes, new implant microand nanotopographies have been introduced in the market. In fact, new surface treatments allow us to obtain microand nano-rough implant surfaces, characterized by a controlled microand nanotopography, able to geometrically stimulate and accelerate the bone healing processes: this can effectively enhance osseointegration, reducing healing times. These are important applications, in dentistry, of the tissue engineering concepts. In the present thematic special issue, we have gathered several well conducted scientific and clinical papers that examine and describe the above concepts. This thematic special issue features a series of clinical studies on the effects of new implant macrotopographies on the implant stability, survival, and success in the short and long term. Moreover, we have collected a series of scientific articles (in vitro studies on cell cultures, in vivo animal histologic/histomorphometric studies, in vivohumanhistologic/histomorphometric studies, and clinical studies) on the effects of new macro-, micro, and nanotopographies on osseointegration. Finally, we are delighted that this issue includes the first human histologic article in the dental literature, reporting on the 5-year results with an innovative strategy for enhancing aesthetics in implant treatment in the anterior maxilla utilising the root membrane/socket shield technique. Only high quality research and clinical papers have been selected and published in the present thematic special issue. We really hope you will enjoy the reading and find it very interesting.

Scanning Electron Microscope (SEM) evaluation of the interface between a nanostructured calcium-incorporated dental implant surface and the human bone

Purpose. The aim of this scanning electron microscope (SEM) study was to investigate the interface between the bone and a novel nanostructured calcium-incorporated dental implant surface in humans. Methods. A dental implant (Anyridge®, Megagen Implant Co., Gyeongbuk, South Korea) with a nanostructured calcium-incorporated surface (Xpeed®, Megagen Implant Co., Gyeongbuk, South Korea), which had been placed a month earlier in a fully healed site of the posterior maxilla (#14) of a 48-year-old female patient, and which had been subjected to immediate functional loading, was removed after a traumatic injury. Despite the violent trauma that caused mobilization of the fixture, its surface appeared to be covered by a firmly attached, intact tissue; therefore, it was subjected to SEM examination. The implant surface of an unused nanostructured calcium-incorporated implant was also observed under SEM, as control. Results. The surface of the unused implant showed a highly-structured texture, carved by irregular, multi-scale hollows reminiscent of a fractal structure. It appeared perfectly clean and devoid of any contamination. The human specimen showed trabecular bone firmly anchored to the implant surface, bridging the screw threads and filling the spaces among them. Conclusions. Within the limits of this human histological report, the sample analyzed showed that the nanostructured calcium-incorporated surface was covered by new bone, one month after placement in the posterior maxilla, under an immediate functional loading protocol.