Review Article

Effect of TiO2 Abutment Coatings on Peri-Implant Soft Tissue Behavior: A Systematic Review of In Vivo Studies

Table 4

Included human studies with their characteristics.

AuthorsCountryStudy typeStudy designNo. of patientsNo. of implantsTiO2 coating techniqueProsthesis typeSoft tissue analysisExposure time

Glauser et al. [47]SwitzerlandNANA5 pt12 Screw-shaped one-piece mini-implant, 2.3 mm × 10 mm (four test four ctr four acid etched)Micro arc oxidation
oxidized and micro—porous TiO2 layer
4 mm cylindrical abutment portion in contact with the soft tissue(i) Clinical observation
(ii) Peri-implant soft tissue barrier (qualitative and quantitative scoring analysis:
(iii) Histological analysis
(iv) Histomorphometric analysis
8 weeks

Schupbach and Glauser [48]SwitzerlandnonrandomizedImplants placed in sequence and/or bilaterally.5 pt12 Screw-shaped one-piece mini-implants (Nobel Biocare AB), 2.3 mm × 10 mm. (four test four ctr four acid etched)oxidized and micro—porous TiO2 layer4 mm cylindrical abutment portion in contact with the soft tissue(i) Structural and ultrastructural features of the interface between transmucosal implants and surrounding tissues
(ii) Histological analysis
(iii) SEM
8 weeks

Wennerberg et al. [41]Sweden & FinlandRandomized allocationSplit mouth15 pt30 experimental micro implants 10 and 13 mm long, × 2.2 mm width), (15 test; 15 ctr)Sol–gel derived TiO2 (MetAlive®, Vivoxid Ltd., Turku, Finland).
Coating thickness = 380 nm
Ra (TiO2 coating) = 0.88 nm
Abutment part 3.4 mm and 6.4 mm long(i) Clinical investigation
(ii) Histological analysis
14 weeks

Göthberg et al. [42]SwedenRandomized allocationControlled parallel50 pt150 Brånemark TiUnite implants (Nobel Biocare AB) (62 test; 64 ctr)Oxidized (TiUnite)Three-unit fixed prosthesis connected directly at implant level or via machined abutment or an oxidized abutment (TiUnite)(i) Soft tissue height coronal from the abutment platform to the mucosal margin
(ii) Plaque index (PI)
(iii) Peri-implant probing pocket depth (PPD)
(iv) Bleeding on probing (BoP)
2 days, 2 and 4 weeks, 3 and 6 months, and 1, 3, and 5 years.

Raes et al. [43]BelgiumRandomized allocationSplit mouth18 patients with a history of severe periodontitis84 Brånemark MK III (Nobel Biocare AB) (42 test; 42 ctr)Oxidized (TiUnite)Full arch fixed or overdenture with machined or oxidized (TiUnite) abutments(i) Probing pocket depth (PPD),
(ii) Clinical attachment level (CAL),
(iii) Bleeding on probing (BoP),
(iv) Microbiological analysis
1, 3, 5 years
Hall et al.[44]SwedenRandomized allocationSplit mouth35 pt70 Brånemark Mk III or Mk IV, (TiUnite, Nobel Biocare AB) (35 test; 35 ctr)Nanostructured anodized coating thickness = 100 nm
Ra = 0.2 μm
abutments with anodized or machined surface(i) Soft tissue assessments:
(ii) Bleeding on probing(BoP)
(iii) Height of keratinized mucosa
(iv) Redness and swelling
(v) Plaque accumulation
(vi) Peri-implant probing depth(PPD)
(vii) Gene expression analysis by qPCR
6-week, 6-month, and 2-year

Dib-Zaitum et al. [45]SpainRandomized allocationSplit mouth10 pt40 endosseous implants (IPX−4010_Galimplant) (20 anodized, 20 machined)AnodizedTransepithelial abutments with anodized or machined surfaces(i) Clinical measurement
(ii) Histological parameter
(iii) Histomorphometric analysis
8 weeks

Farrag and khamis [46]EgyptRandomized allocationSplit mouth30 pt60 Screw bone-level implants (Dentium)(30 test; 30 ctr)Anodizedcement-retained crowns on anodized or non-anodized abutments(i) Clinical parameters:
(ii) Peri-implant probing depth (PPD)
(iii) Soft tissue recession
(iv) Modified sulcus bleeding index
(v) Modified plaque index
(vi) Modified gingival index
At insertion (baseline), 3, 6, 12 and 18 months

Abbreviations: NA, not available; ctr, control; qPCR, quantitative polymerase chain reaction; SEM, scanning electron microscope; Ra, the arithmetic average of the absolute values of the profile heights; and pt, patients.