Developments in material science not just lighten up the unknowns, it rotates the dental materials to new roads as well. There are more studies still performing on the dental implant materials. However, when it comes the material biocompatibility with the oral flora and surrounding bone, the growing options are lean on the proven materials- like Titanium.

Titanium (Ti) is considered to be one of the most used metal in dental implants. The first dental implant was come across in BC 2600. Even if the deep history of dental implant, the threaded pure Titanium dental implant joined the timeline in 1952 by Brånemark [1]. Based on this evolutionary milestone, Titanium and it’s alloys was considered as one of the main objectives as dental implant material.

What is expected from a material for dental implant? Different prospects are needed to be considered as material’ chemical and mechanic properties, biological compatibility, and moderate production costs.

In chemical aspect, pure Titanium (CpTi) has four different “purity” grades according to their chemical composition [2]. The difference of these grades depend on the mainly oxygen and iron quantity in the Titanium composition. From Grade I to Grade IV, decreased “impurities” and increased in material strength exist [2]. Impurities are related to different elements in Titanium composition. In addition these four purity grades, there are two commonly used titanium alloys as Ti-6Al-4V and Ti-6Al-4V-ELI (extra low interstitial alloy) for dental material [3]. Dental implant manufacturers tend to use CpTi Grade IV and these commercial alloys, generally named as Ti Gr 5. Superior strenght and low Young modulus value, Ti Gr 5 can be an option. However, literature shows some problems on TiGr5 usage regarding toxic effects of vanadium and aluminum addition in chemical composition [5].

Natural tooth has its own characteristic. All we do with the implant treatments with all processes including implant and prosthetic parts, is a different type of biomimicry. When it comes the teeth and also the bone, the mechanical strength should be estimated. Titanium is a metal with a good mechanical stability, low Young modulus value, low density 4.5 g/cm3), a high strength-to-weight ratio, corrosion resistant, and especially high fatigue strength [2,5]. Among all the pure Titanium grades, Ti Gr4 has modulus of 204 GPa, tensile strenght as 550 MPa, yield strenght as 483 MPa, elongation as 15% and density of 4.5 [1].  That’s the mechanical reason why to TiGr4 is used commonly for implants. For TiGr5, some mechanical concerns arise from the relatively high Young modulus value but more studies needed to published for true evaluation [2].

Osseointegration and biocompatibility leads these improvements on material science of dental implants. As biodynamic evaluation, Titanium and its alloys are bioinert [7]. In studies of Titanium implants, calcium phosphate formation ability, evaluation of osteoblast activity, bone formation, bone contacting rate, and bone bonding strength [9]. The initative response for all these conveniences starting with formation of TiO2 layer. This layer is formed when the implants is contact with air and water naturally. TiO2 layer forms approximate thickness of 4-6 mm with bond profile containing hydroxyl groups [8]. This surface has a boosting effect on bone cells (osteoblasts) adhesion [8]. It results as more effective and quicker osseointegration which is important for implant stability as well. It also leads the bone formation in long time.  In oral environment and physiology, TiGr4 and TiGr5 shows different properties related to the body temperature and saliva characteristics. In 37 °C, TiGr5 corrosion resistance decreases more from TiGr4 [10]. Another concern of TiGr5 usage as dental implants is potential toxicity of vanadium composition. Increased aluminum concentration and vanadium releases lead structural deficiencies, problems in bone mineralization and allergic reactions [8].

As overall evaluation, TiGr4 is one of the good options for dental implant materials with its chemical composition, mechanical properties and increased biocompatibility.

NUVO offers CpTi Gr 4 implants in both of InternalFIT and ConicalFIT portfolio. Let’s check out NUVO product portfolio and please visit us from here.

References:

[1] Oza, Unnati, et al. "Dental Implant Biomaterials: A Comprehensive Review." (2020).
[2] Masa, Roland, and G. Braunitzer. "Titanium and its alloys in dental implantology." Implants 18.4 (2017): 6-12.
[3] Osman, Reham B., and Michael V. Swain. "A critical review of dental implant materials with an emphasis on titanium versus zirconia." Materials 8.3 (2015): 932-958.
[4] Silva, Rayane CS, et al. "Titanium Dental Implants: An Overview of Applied Nanobiotechnology to Improve Biocompatibility and Prevent Infections." Materials 15.9 (2022): 3150.
[5] Srivastava, Suneel Kumar, and Barnali Ghosh Pal. "Metallic biomaterials for dental implant systems." Fundamental Biomaterials: Metals. Woodhead Publishing, 2018. 111-137.
[6] Najeeb, Shariq, et al. "Dental implants materials and surface treatments." Advanced dental biomaterials. Woodhead Publishing, 2019. 581-598.
[7] Sykaras, Nikitas, et al. "Implant materials, designs, and surface topographies: their effect on osseointegration. A literature review." International Journal of Oral & Maxillofacial Implants 15.5 (2000).
[8] W. Nicholson, John. "Titanium alloys for dental implants: A review." Prosthesis 2.2 (2020): 11. [9] Titanium–Tissue Interface Reaction and Its Control With Surface Treatment
[10] Sukumaran, Binsu, et al. "Effects of dental implant corrosion-A Review." European Journal of Molecular & Clinical Medicine 7.07 (2021): 2020.