Publication: Cambio en la rugosidad de superficie de implantes dentales tras su inserción en hueso denso
Authors
Báguena Pérez-Crespo, Ángela
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Escuela Internacional de Doctorado
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Nicolás Silvente, Ana Isabel
Publisher
Universidad de Murcia
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DOI
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info:eu-repo/semantics/doctoralThesis
Description
Abstract
La osteointegración de los implantes dentales depende en gran medida de las características de su superficie, especialmente de su rugosidad, la cual influye en la adhesión celular, la estabilidad primaria y la cicatrización ósea. Sin embargo, durante el proceso de inserción quirúrgica, las superficies implantarias pueden sufrir modificaciones microtopográficas debido a la fricción contra las paredes del lecho óseo, lo que podría alterar sus propiedades biológicas y mecánicas.
El objetivo principal de esta tesis fue evaluar si se producen alteraciones en la microtopografía superficial de seis modelos comerciales de implantes dentales tras su inserción y desinserción en un modelo in vitro de hueso denso tipo II, mediante análisis de rugosidad tridimensional. Los objetivos secundarios incluyeron comparar los cambios en distintas zonas del implante, analizar el impacto del tratamiento de superficie y la composición química, evaluar la afectación de la macromorfología de las espiras y determinar la precisión del análisis tridimensional mediante microscopía láser confocal para detectar las alteraciones postinserción.
Se diseñó un estudio piloto in vitro en el que treinta implantes de seis diseños y superficies diferentes (Anker, Ankylos, Intralock, Nobel Replace, Straumann BLT y Straumann Tapered Effect) fueron insertados en bloques de hueso artificial tipo II bajo un torque de 50-60 Ncm. Se analizó la rugosidad superficial antes y después de la inserción mediante microscopía láser confocal (Keyence VK-X150), midiendo parámetros como Sa, Sz, Sq, Sdr y Spd en cuatro zonas anatómicas del implante: cuello, tercio coronal, tercio medio y ápice. El análisis estadístico se realizó mediante prueba t para muestras relacionadas.
Los resultados mostraron que todos los diseños implantarios analizados presentaron disminuciones en sus valores de rugosidad tridimensional tras la inserción, especialmente en los parámetros Sa, Sq y Sdr, considerados clave en la caracterización topográfica. Las zonas más afectadas fueron el tercio medio y el ápice, coincidiendo con las áreas de mayor contacto friccional durante la inserción.
La magnitud del cambio estuvo influida por la composición y el tratamiento de superficie. Implantes sometidos a tratamientos más agresivos como arenado con partículas y grabado ácido (Straumann BLT, Nobel Replace) presentaron mayor pérdida de microestructura, especialmente en parámetros como Sdr y Sz. En contraste, los implantes con superficies más pasivadas o menos agresivasn(Ankylos, Straumann Tapered Effect) mostraron mayor estabilidad topográfica postinserción.
Aunque no se observaron deformaciones macroscópicas severas, se detectaron cambios morfológicos leves en los bordes de las espiras, sugiriendo que el diseño macroscópico condiciona la resistencia local frente a la fricción mecánica. Este hallazgo refuerza la necesidad de considerar simultáneamente química superficial, microtopografía y diseño estructural en el desarrollo de implantes con mejores resultados clínicos.
En conclusión, este estudio confirma que la inserción en hueso denso produce modificaciones detectables en la superficie implantaria, y que estas dependen tanto de la zona del implante como de sus características superficiales y químicas. Asimismo, la microscopía láser confocal se mostró como una herramienta eficaz para el análisis tridimensional de superficies, permitiendo cuantificar con precisión los cambios inducidos tras la inserción. Estos resultados subrayan la importancia de seguir investigando la estabilidad superficial de los implantes bajo condiciones clínicas reales para mejorar su rendimiento a largo plazo.
The osseointegration of dental implants relies heavily on surface characteristics, particularly surface roughness, which plays a crucial role in cell adhesion, primary stability, and bone healing. However, during surgical insertion, implant surfaces are subjected to frictional forces that may induce microtopographical changes, potentially modifying their biological and mechanical behavior. The main objective of this thesis was to investigate whether microtopographical alterations occur in six commercial dental implant systems after insertion and removal in a type II dense bone in vitro model, utilizing three-dimensional surface roughness analysis. Secondary objectives included comparing changes across different implant regions, assessing the influence of implant composition and surface treatment, evaluating possible changes to macro-thread morphology, and determining the accuracy of laser confocal microscopy in detecting post-insertion alterations. A pilot in vitro study was designed using thirty implants of six different macro- and microdesigns (Anker, Ankylos, Intralock, Nobel Replace, Straumann BLT, and Straumann Tapered Effect). All samples were inserted into artificial type II bone blocks under a 50-60 Ncm torque following manufacturer protocols. A laser confocal microscope (Keyence VK-X150) was used to assess surface roughness before and after insertion, measuring Sa, Sz, Sq, Sdr, and Spd at four anatomical regions: neck, coronal third, middle third, and apical area. Statistical analysis was performed using a paired t-test. The results showed that all implant designs analyzed exhibited decreases in their three-dimensional roughness values after insertion, particularly in the Sa, Sq, and Sdr parameters, which are considered key in topographical characterization. The most affected regions were the middle third and the apex, coinciding with the areas of greatest frictional contact during insertion. The magnitude of change was influenced by the surface composition and treatment. Implants subjected to more aggressive treatments such as particle blasting and acid etching (Straumann BLT, Nobel Replace) showed greater loss of microstructure, especially in parameters such as Sdr and Sz. In contrast, implants with more passive or less aggressive surfaces (Ankylos, Straumann Tapered Effect) demonstrated greater topographical stability after insertion. Although no severe macroscopic deformations were observed, slight morphological changes were detected at the thread edges, suggesting that macroscopic design influences local resistance to mechanical friction. This finding reinforces the need to simultaneously consider surface chemistry, microtopography, and structural design in the development of implants with improved clinical outcomes. In conclusion, this study confirms that insertion into dense bone leads to measurable alterations in implant surface topography, influenced by anatomical location, surface treatment, and material composition. Laser confocal microscopy proved to be a highly effective tool for three-dimensional surface characterization, enabling precise quantification of insertion-induced changes. These findings underscore the need for further research into implant surface stability under clinical conditions to improve long-term biomechanical and biological performance.
The osseointegration of dental implants relies heavily on surface characteristics, particularly surface roughness, which plays a crucial role in cell adhesion, primary stability, and bone healing. However, during surgical insertion, implant surfaces are subjected to frictional forces that may induce microtopographical changes, potentially modifying their biological and mechanical behavior. The main objective of this thesis was to investigate whether microtopographical alterations occur in six commercial dental implant systems after insertion and removal in a type II dense bone in vitro model, utilizing three-dimensional surface roughness analysis. Secondary objectives included comparing changes across different implant regions, assessing the influence of implant composition and surface treatment, evaluating possible changes to macro-thread morphology, and determining the accuracy of laser confocal microscopy in detecting post-insertion alterations. A pilot in vitro study was designed using thirty implants of six different macro- and microdesigns (Anker, Ankylos, Intralock, Nobel Replace, Straumann BLT, and Straumann Tapered Effect). All samples were inserted into artificial type II bone blocks under a 50-60 Ncm torque following manufacturer protocols. A laser confocal microscope (Keyence VK-X150) was used to assess surface roughness before and after insertion, measuring Sa, Sz, Sq, Sdr, and Spd at four anatomical regions: neck, coronal third, middle third, and apical area. Statistical analysis was performed using a paired t-test. The results showed that all implant designs analyzed exhibited decreases in their three-dimensional roughness values after insertion, particularly in the Sa, Sq, and Sdr parameters, which are considered key in topographical characterization. The most affected regions were the middle third and the apex, coinciding with the areas of greatest frictional contact during insertion. The magnitude of change was influenced by the surface composition and treatment. Implants subjected to more aggressive treatments such as particle blasting and acid etching (Straumann BLT, Nobel Replace) showed greater loss of microstructure, especially in parameters such as Sdr and Sz. In contrast, implants with more passive or less aggressive surfaces (Ankylos, Straumann Tapered Effect) demonstrated greater topographical stability after insertion. Although no severe macroscopic deformations were observed, slight morphological changes were detected at the thread edges, suggesting that macroscopic design influences local resistance to mechanical friction. This finding reinforces the need to simultaneously consider surface chemistry, microtopography, and structural design in the development of implants with improved clinical outcomes. In conclusion, this study confirms that insertion into dense bone leads to measurable alterations in implant surface topography, influenced by anatomical location, surface treatment, and material composition. Laser confocal microscopy proved to be a highly effective tool for three-dimensional surface characterization, enabling precise quantification of insertion-induced changes. These findings underscore the need for further research into implant surface stability under clinical conditions to improve long-term biomechanical and biological performance.
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