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Table 4 Modification of dental implant surfaces with ECM

From: Dental implant bioactive surface modifications and their effects on osseointegration: a review

Author Animal – bone site Surface modification Length of study Findings
Morra et al. [45] Rabbit – femur 1. pTi: anodization of titanium implant
2. ColpTi: collagen coated titanium implant
4 weeks % of BIC
- pTi: 36.9%
- ColpTi: 63.7%
% of bone ingrowth
- pTi: 29.0%
- ColpTi: 43.3%
Schliephake et al. [46] Dog - mandible 1. Machined titanium surface (control)
2. Machine + Collagen I (collagen only)
3. Machine + calcium phosphate (HA-only)
4. Machine + calcium phosphate + Collagen I (composite)
1 and 3 months % of BIC
- Control: 31.5% at 1 month, 41.2% at 3 months
- Collagen-only: 41.9% at 1 month, 60.2% at 3 months
- HA-only: 45.2% at 1 month, 61.7% at 3 months
- Composite: 62.6% at 1 month, 59.0% at 3 months
BVD
- Control: 16.1% at 1 month, 40.6% at 3 months
- Collagen-only: 22.9% at 1 month, 62.6% at 3 months
- HA-only: 33.0% at 1 month, 58.5% at 3 months
- Composite: 40.9% at 1 month, 67.3% at 3 months
Stadlinger et al. [47] Pig – mandible 1. Coll: collagen type I
2. Coll/CS: collagen type I + chondroitin sulfate
3. Coll/CS/BMP: collagen type I + chondroitin sulfate + BMP-4
22 weeks % of BIC
- Coll: 45%
- Coll/CS: 55%
- Coll/CS/BMP: 41%
Implant stability test at 22 weeks
- Coll: ISQ = 73
- Coll/CS: ISQ = 69
- Coll/CS/BMP: ISQ = 67
Ferguson et al. [48] Sheep – pelvis 1. Ti: sandblasted and acid-etched titanium
2. Zir: sandblasted and etched zirconia
3. CaP: Ti coated with calcium phosphate
4. APC: Ti modified via anodic plasma-chemical treatment
5. Bisphos: bisphosphonate coated Ti
6. Coll/CS: Ti coated with collagen containing chondroitin sulfate
8 weeks Removal torque values at 8 weeks (N-mm)
- Ti: 1,884
- Zir: 1,005
- CaP: 1,683
- APC: 919
- Bisphos: 1,835
- Coll/CS: 1,593
Stadlinger et al. [49] Pig – mandible 1. Coll: collagen coated Ti
2. Coll/DC: collagen + DC
3. Coll/CS: collagen + CS
4. Coll/DC/TGF: collagen + DC + TGF- β1
5. Coll/CS/BMP: collagen + CS + BMP-4
6. Coll/DC/CS/BMP/TGF: collagen + DC + CS + BMP-4 + TGF- β1
3, 4, 5 and 6 weeks % of BIC at 3, 4, 5, and 6 weeks Total
- Coll: 12.45%
- Coll/DC: 12.65%
- Coll/CS: 28.28%
- Coll/DC/TGF: 16.27%
- Coll/CS/BMP: 22.92%
- Coll/DC/CS/BMP/TGF: 11.43%
Stadlinger et al. [50] Pig – mandible 1. Coll: collagen
2. Coll/CS: collagen + CS
3. Coll/CS/BMP-4: collagen + CS + rhBMP-4
6 months % of BIC
- Coll: 30%
- Coll/CS: 40%
- Coll/CS/rhBMP-4: 27%
Langhoff et al. [51] Sheep – pelvis 1. Control: sandblasted and acid-etched Ti
2. CaP: calcium phosphate coated
3. APC: plasma anodized
4. Coll/CS: collagen + CS coated
5. Bisphos: bisphosphonate coated
6. Zir: sandblasted and etched zirconia
8 weeks - All implants were well osseointegrated
- No significant differences in % of BIC
Schliephake et al. [52] Dog – mandible 1. MS: machined surface
2. DAE: dual acid-etched surface
3. RGD: RGD + DAE
4. Coll: collagen I + DAE
5. Coll/CS: collagen I + CS + DAE
6. Coll/CS/BMP-2: collagen I + CS + BMP-2 + DAE
4 and 12 weeks % of BIC
- MS: 25.4% at 4 weeks, 37.7% at 12 weeks
- DAE: 40.9% at 4 weeks, 57.6% at 12 weeks
- RGD: 41.4% at 4 weeks, 59.4% at 12 weeks
- Coll: 40.4% at 4 weeks, 56.3% at 12 weeks
- Coll/CS: 31.1% at 4 weeks, 66.4% at 12 weeks
- Coll/CS/BMP-2: 43.7% at 4 weeks, 60.6% at 12 weeks
Stadlinger et al. [53] Pig – mandible 1. Control: sandblasted and acid-etched Ti
2. Coll/CS1: Ti + collagen + low dose CS
3. Coll/CS2: Ti + collagen + high dose CS
1 and 2 months % of BIC for the entire implant at 1 and 2 months
- Control: 51.6% at 1 month, 62.7% at 2 months
- Coll/CS1: 68.4% at 1 month, 71% at 2 months
- Coll/CS2: 63.1% at 1 month, 67.9% at 2 months
Morra et al. [54] Rabbit – femur and tibia 1. Ti: acid-etched titanium
2. CollTi: collagen type I + Ti
2 and 4 weeks % of BIC was significantly higher around CollTi when compared with Ti both in femur and tibia at 2 weeks. No significant differences were observed at 4 weeks.
Alghamdi et al. [55] Dog - mandible 1. Ti (control)
2. Nano-CaP-coated
3. Type I collagen coated
4 and 12 weeks Overall BV
- Ti: 47.5% at 4 weeks; 65.1% at 12 weeks
- Nano-CaP: 49.5% at 4 weeks; 67.2% at 12 weeks
- Collagen: 61.4% at 4 weeks; 72.7 at 12 weeks
Inner zone BV
- Ti: 10.5% at 4 weeks; 37.5% at 12 weeks
- Nano-CaP: 23.1% at 4 weeks; 38.2% at 12 weeks
- Collagen: 28.4% at 4 weeks; 52.4 at 12 week
Stadlinger et al. [56] Pig - maxilla 1. SAE
2. Collagen type I coating (Coll)
3. Coll + CS (low amount)
4. Coll + CS (high amount)
5. Coll + high-SH
6. Coll + low-SH
4 and 8 weeks % of BIC
- SAE: 56% at 4 weeks; 66.4% at 8 weeks
- Coll: 36.8% at 4 weeks; 68.7% at 8 weeks
- Coll + CS (low): 70.4% at 4 weeks; 74.7% at 8 weeks
- Coll + CS (high): 51.2% at 4 weeks; 63.5% at 8 weeks
- Coll + high-SH: 50.3% at 4 weeks; 64.3% at 8 weeks
- Coll + low-SH: 53.9% at 4 weeks; 65.5% at 8 weeks
BVD
- SAE: 23.2% at 4 weeks; 45.2% at 8 weeks
- Coll: 26.2% at 4 weeks; 48.9% at 8 weeks
- Coll + CS (low): 28.1% at 4 weeks; 54.9% at 8 weeks
- Coll + CS (high): 27.4% at 4 weeks; 45.2% at 8 weeks
- Coll + high-SH: 23.6% at 4 weeks; 42.9% at 8 weeks
- Coll + low-SH: 21.8% at 4 weeks; 46.9% at 8 weeks
Lee et al. [57] Rabbit - tibia 1. AE (control)
2. HA coating
3. Coll + HA coating
4. Coll + HA + BMP-2 coating
6 weeks % of BIC
- AE: 21.38%
- HA coating: 24.18%
- Coll + HA coating: 41.45%
- Coll + HA + BMP-2 coating: 30.72%
  1. ECM extracellular matrix; HA hydroxyapatite; BVD newly formed peri-implant bone; BMP-4 bone morphogenetic protein-4; Ti titanium implant; ISQ implant stability quotient; CaP calcium phosphate; Bisphos bisphosphonate; CS chondroitin sulfate; DC decorin; TGF-β1 transforming growth factor β1; rhBMP-4 recombinant human bone morphogenetic protein-4; RGD RGD peptide; SH sulfate hyaluronan; AE acid-etched
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