title: A review of improved fixation methods for dental implants. Part I: Surface optimization for rapid osseointegration.
abstract: OBJECTIVE
  Titanium is a primary metallic biomaterial used in load-bearing orthopedic or dental implants because of its favorable mechanical properties and osseointegration capability. This article reviews the current status of surface optimization techniques for titanium implants, whether such concepts are in the form of sufficiently evidence-based, and highlights the related experimental tools.
  
  
  METHODS
  A strong emphasis was placed on the enhanced biological responses to titanium implants by modifying the surface finishing process. On this basis, a clear partition of surface chemistry and topography was critical.
  
  
  RESULTS
  The intrinsic host tissue response to titanium implants is facilitated by the chemistry or topography of a passive oxide film, although the extent to which the surface characteristics enable rapid osseointegration is still uncertain.
  
  
  CONCLUSIONS
  Besides the fundamental requirements, such as the promotion of osteogenic differentiation, the titanium implant surface should accelerate wound-healing phenomena prior to bone ingrowth toward the surface. Moreover, because initial bacterial attachment to the implant surface is unavoidable, infection control by surface modification is also an important determinant in reducing surgical failure. A desirable surface-biological relationship often needs to be characterized at the nanoscale by means of advanced technologies.
authors.affiliation: Department of Conservative Dentistry, Division of Biomaterials & Engineering, Showa University School of Dentistry, Tokyo, Japan. Electronic address: yookun@dent.showa-u.ac.jp.
authors.forename: Yo
authors.initials: Y
authors.lastname: Shibata
authors.affiliation: Department of Dental Biomaterials, Nihon University School of Dentistry at Matsudo, Chiba, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tanimoto
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001422:Bacterial Adhesion; D001842:Bone and Bones / Q000502:physiology*; D003757:Dental Implantation / Q000379:methods*; D015921:Dental Implants / Q000382:microbiology; D004202:Disinfectants / Q000008:administration & dosage; D055094:Evidence-Based Dentistry; D006801:Humans; D049329:Nanostructures / Q000737:chemistry / Q000382:microbiology; D016348:Osseointegration / Q000502:physiology*; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage; D013499:Surface Properties; D014025:Titanium / Q000737:chemistry; D014945:Wound Healing
chemical_list: D000900:Anti-Bacterial Agents; D015921:Dental Implants; D004202:Disinfectants; D012462:Saline Solution, Hypertonic; D014025:Titanium
keywords: Antibacterial; Osseointegration; Surface chemistry; Surface topography; Titanium implant