Table Of ContentWoodhead Publishing Series in Biomaterials
Dental Implants
Materials, Coatings, Surface Modifications and
Interfaces with Oral Tissues
Edited by
Muhammad Sohail Zafar
Zohaib Khurshid
Associate editors
Abdul Samad Khan
Shariq Najeeb
Farshid Sefat
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Contributors
Zohaib Akram Department of Periodontology, Ziauddin University, Karachi,
Pakistan
Sajeda Al Banna Department of Oral and Maxillofacial Surgery, Al-Salt Public
Hospital, Amman, Jordan
Shahid Ali Department of Science of Dental Materials, Bibi Aseefa Dental College,
Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, Pakistan
Nujood Ibrahim Alyousef College of Dentistry, Imam Abdulrahman Bin Faisal
University, Dammam, Saudi Arabia
Yara Khalid AlMaimouni Department of Restorative Dental Sciences, College of
Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
Ahmad A. Alnazzawi Department of Substitutive Dental Sciences, College of
Dentistry, Taibah University, Al Madina, Al Munawwarrah, Saudi Arabia
Mothanna Alrahabi Department of Restorative Dentistry, College of Dentistry,
Taibah University, Al Madina, Al Munawwarrah, Saudi Arabia
Faris Yahya I. Asiri Department of Preventive Dentistry, College of Dentistry, King
Faisal University, Al-Ahsa, Saudi Arabia
Saira Attique Institute of Chemistry, University of the Punjab, New Campus,
Lahore, Pakistan
Mohmaed Wagdy Bissa Periodontology Department, Faculty of Dentistry, Ain-
Shams University, Cairo, Egypt
Mashael Abdullah Benrashed Department of Biomedical Sciences, College of
Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
Wen Lin Chai Department of Restorative Dentistry, Faculty of Dentistry, University
of Malaya, Kuala Lumpur, Malaysia
Ahmed El-Banna Faculty of Dentistry, Ain-Shams University, Cairo, Egypt
Ala’ Ersheidat Periodontist, Royal Medical Services, Jordanian Armed Forces
Amman, Jordan
Muhammad Amber Fareed Adult Restorative Dentistry, Dental Biomaterials and
Prosthodontics Oman Dental College, Muscat, Sultanate of Oman
Hani Ghabbani Department of Restorative Dentistry, College of Dentistry, Taibah
University, Al Madina, Al Munawwarrah, Saudi Arabia
xii Contributors
Oliver Goerke Technische Universität Berlin, Fakultät III Prozesswissenschaften,
Institut für Werkstoffwissenschaften und -technologien, Fachgebiet Keramische
Werkstoffe, Berlin, Germany
Syed Rashid Habib Department of Prosthetic Dental Sciences, College of Dentistry,
King Saud University, Riyadh, Saudi Arabia
Saudah Hafeji Biomedical and Electrical Engineering Department, School of
Engineering, University of Bradford, Bradford, United Kingdom
Ahmed Hashim Department of Biological Sciences, College of Dentistry, King
Faisal University, Al-Ahsa, Saudi Arabia
Fawad Javed Division of Orthodontics and Dentofacial Orthopedics, Eastman
Institute for Oral Health, University of Rochester, NY, United States
Junad Khan Department of Orofacial Pain and TMJ Disorders, Eastman Institute
for Oral Health, University of Rochester, NY, United States
Naresh Kumar Department of Science of Dental Materials, Dow University of
Health Sciences, Karachi, Pakistan
Bharat Kumar Department of Prosthodontics, Dow University of Health Sciences,
Karachi, Pakistan
Abdul Samad Khan Department of Restorative Dental Sciences, College of
Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
Zohaib Khurshid Department of Prosthodontics and Dental Implantology, College
of Dentistry, King Faisal University, Al-Ahsa, Saudi Arabia
Muhammad Latif Centre for Genetics and Inherited Diseases (CGID), Taibah
University, Al Madina, Al Munawwarrah, Saudi Arabia
Daniel Lim Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
Vinay Marla Penang International Dental College, Butterworth, Penang, Malaysia
Keyvan Moharamzadeh Academic Unit of Restorative Dentistry, School of
Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
Shariq Najeeb Department of Anatomy and Cell Biology, Schulich School of
Medicine & Dentistry, Western University, London, Ontario, Canada
Wei Cheong Ngeow Faculty of Dentistry, University of Malaya, Kuala Lumpur,
Malaysia
Syed Mariam Raza Department of Sciences of Dental Materials, PMC Dental
Institute, Faisalabad Medical University, Faisalabad, Pakistan
Masfueh Razali Centre of Restorative Dentistry, Faculty of Dentistry, Universiti
Kebangsaan Malaysia, Kuala Lumpur, Malaysia
Contributors xiii
Samiya Riaz School of Dental Sciences, Universiti Sains Malaysia Health Campus,
Kelantan, Malaysia
Muhammad Atiq ur Rehman Department of Materials Science and Engineering,
Institute of Space Technology Islamabad, Pakistan
Mehwish Saleem Department of Dental Biomaterials, Bakhtawar Amin College of
Dentistry, Multan, Pakistan
Farshid Sefat Biomedical and Electrical Engineering Department, School of
Engineering, University of Bradford, Bradford; Interdisciplinary Research Centre in
Polymer Science & Technology (IRC Polymer), University of Bradford, Bradford,
United Kingdom
Asma Tufail Shah Interdisciplinary Research Centre in Biomedical Materials,
COMSATS University, Islamabad, Lahore Campus, Lahore, Pakistan
Naresh Shetty School of Dentistry, International Medical University, Kuala Lumpur,
Malaysia
Chuey Chuan Tan Faculty of Dentistry, University of Malaya, Kuala Lumpur,
Malaysia
Samet Tekin Firat University, Faculty of Dentistry, Department of Prosthodontics,
Elazig, Turkey
Rizwan Ullah Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical
University, Karachi, Pakistan
Syed Azeem Ul Yaqin Department of Prosthodontics and Dental Implantology,
College of Dentistry, King Faisal University, Al-Ahsa, Saudi Arabia
Muhammad Sohail Zafar Department of Restorative Dentistry, College of
Dentistry, Taibah University, Al Madina, Al Munawwarrah, Saudi Arabia;
Department of Dental Materials, Islamic International Dental College, Riphah
International University, Islamabad, Pakistan
Sana Zohaib Department of Biomedical Engineering, College of Engineering, King
Faisal University, Al-Ahsa, Saudi Arabia
Introduction to dental implants 1
materials, coatings, and surface
modifications
Muhammad Sohail Zafara,b, Shariq Najeebc, Zohaib Khurshidd
aDepartment of Restorative Dentistry, College of Dentistry, Taibah University, Al Madina,
Al Munawwarrah, Saudi Arabia; bDepartment of Dental Materials, Islamic International
Dental College, Riphah International University, Islamabad, Pakistan; cDepartment of
Anatomy and Cell Biology, Schulich School of Medicine & Dentistry, Western University,
London, Ontario, Canada; dDepartment of Prosthodontics and Dental Implantology,
College of Dentistry, King Faisal University, Al-Ahsa, Saudi Arabia
Dental implants are devices that are surgically inserted into the maxillary and/or man-
dibular alveolar bone restoring lost teeth. Ideally, dental implants should have a direct
contact with the bone: a phenomenon known as osseointegration (Albrektsson and
Johansson, 2001). In order to improve the osseointegration, a variety of modifica-
tions in the implant surface have been investigated such as surface treatments (Le
Guéhennec et al., 2007; Najeeb et al., 2019; Novaes et al., 2010) and surface coatings
(Najeeb et al., 2016a; Najeeb et al., 2017; Xuereb et al., 2015). Over the past several
decades, there have been numerous advancements in the science of dental implant bio-
materials and the clinical applications of dental implants (Guglielmotti et al., 2019).
However, earliest use of dental implants can be traced back to the ancient civiliza-
tions. Archeological surveys have found human remains with primitive implants made
of animal and human teeth, ivory, and gold. Modern osseointegrated dental implants
were developed by Brånemark and Albrektsson (Albrektsson et al., 1981). Dental
implants have evolved from merely pieces of titanium screws to bioactive biomedical
aimed at promoting osseointegration and preventing infections (Zafar et al., 2019).
The aim of this book is not only to provide an overview of those advancements but
also provide the reader an insight into the probable future of dental implant materials,
including various surface treatments and coatings on titanium implants.
Chapter 2 describes the physical, biological, and chemical properties of the most
commonly used dental implant material (titanium) and details the attributes of newer
materials such as the polymer polyetheretherketone (PEEK) (Najeeb et al., 2016b) and
the ceramic zirconia (Özkurt and Kazazog˘lu, 2011; Sollazzo et al., 2008). Chapter 3
compares the clinical aspects of single tooth dental implant and endodontic treatment
options. In addition, various factors affecting implant and endodontic management
and respective prognosis have been discussed. Chapter 4 provides descriptions of
the various manufacturing processes involved in the fabrication of dental implants
and their surface modifications. Chapter 5 and 6 discuss an overview of hydroxyapa-
tite-based and bioglass-based bioactive dental implant coatings. In last two decades,
Dental Implants. http://dx.doi.org/10.1016/B978-0-12-819586-4.00001-9
Copyright © 2020 Elsevier Ltd. All rights reserved.
2 Dental Implants
oral proteins and peptides (such as defensins, cathelicidins, and histatins) have been
utilized in the field of dental biomaterials (Khurshid et al., 2016, 2017a, b, 2018).
Oral defensins, and its motifs proved their antibacterial activity against streptococcus
epidermidis and pseudomonas aeruginosa (Khurshid, 2015). Also, purity of these
proteins can help to design new coating strategies around dental implant for reducing
peri-implantitis. Authors describe the various protein-based implant surface coatings
in Chapter 7, while Chapter 8 emphasizes the recent advancements of dental implants
with growth factor coatings. Similarly, silica-based materials are well known for
inducing bioactivity and have been widely used in dentistry (Khalid et al., 2017;
Skallevold et al., 2019), Therefore, Chapter 9 discusses the antibacterial silica-based
materials for implant coatings. The understanding of biological and clinical aspects
and the factors affecting the interface of implant materials and oral soft and hard
tissues have been highlighted in Chapter 10 and regenerative aspects in Chapter 11,
respectively.
Localized release of therapeutic drugs has shown promising results in implant out-
come (Hamlekhan et al., 2015; Water et al., 2015); Chapter 12 discusses the various
prospects of drug-releasing dental implants. Chapter 13 discusses the microbiologi-
cal aspect of dental implants including oral microbial ecology, biofilm, and peri-
implantitis associated microbiome. Although, dental implants are not contraindicated
in various medical condition, special clinical measures and materials modifications
are beneficial. For example, osteogenic surface coated implants improved osseoin-
tegration in osteoporotic-like conditions (Ghanem et al., 2017; Javed et al., 2014).
Chapter 14 discusses various dental implant modifications for medically compro-
mised patients and systematic diseases. In spite of plenty of research on implant mate-
rials and their modification in recent years, there no ideal material has been identified.
A further research is in progress in search of materials with improved properties for
dental implant applications. Silicon nitride is an emerging material for dental implant
applications; its future trends and prospects have been included in Chapter 15. This
book has gathered information about various implant materials, modifications, surface
treatments, implant biomaterials-tissues interaction, and associated clinical implica-
tion at one point. In addition, wherever possible, authors have supplemented the text
with schematic diagrams, illustrations, and tables.
References
Albrektsson, T., Johansson, C., 2001. Osteoinduction, osteoconduction and osseointegration.
Eur. Spine J. 10 (2), S96–S101.
Albrektsson, T., Brånemark, P.I., Hansson, H.A., Lindström, J., 1981. Osseointegrated titanium
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man. Acta Orthopaed. Scand. 52 (2), 155–170.
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4 Dental Implants
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