The Biological Impact of Residual Aluminum Particles on Sand-Blasted Dental Implant Surfaces: A Systematic Review of Animal Studies
Abstract
:1. Introduction
2. Materials and Methods
2.1. Search Strategy
2.2. Inclusion and Exclusion Criteria
- In vivo experimental animal studies evaluating the biological effects of residual Al particles on Al2O3-blasted dental implant surfaces.
- Studies published in peer-reviewed journals.
- Articles available in English.
- Studies not involving dental implants.
- Reviews, editorials, and opinion pieces without original data.
- Studies not focusing on Al particles or residual Al contamination.
2.3. Study Selection
2.4. Data Extraction
2.5. Quality Assessment
2.6. Data Synthesis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Database | Search String | Records |
---|---|---|
PubMed | (“Dental Implants” [MeSH Terms] OR “Dental Implants” [Title/Abstract] OR “Titanium Implants” [Title/Abstract]) AND (“Aluminum Particles” [Title/Abstract] OR “Alumina Oxide” [Title/Abstract]) AND (“Surface Properties” [MeSH Terms] OR “Surface Contamination” [Title/Abstract] OR “Surface Modification” [Title/Abstract]) AND (“Osseointegration” [MeSH Terms] OR Biocompatibility OR “Biological Effects” [Title/Abstract]) | 88 |
Scopus | (TITLE-ABS-KEY (“Dental Implants”) OR TITLE-ABS-KEY (“Titanium Implants”)) AND (TITLE-ABS-KEY (“Aluminum Particles”) OR TITLE-ABS-KEY (“Alumina Oxide”)) AND (TITLE-ABS-KEY (“Surface Properties”) OR TITLE-ABS-KEY (“Surface Contamination”) OR TITLE-ABS-KEY (“Surface Modification”)) AND (TITLE-ABS-KEY (“Osseointegration”) OR TITLE-ABS-KEY (“Biocompatibility”) OR TITLE-ABS-KEY (“Biological Effects”) | 1320 |
Web of Science | (TS = (“Dental Implants” OR “Titanium Implants”)) AND (TS = (“Aluminum” OR “Aluminum Particles” OR “Alumina Oxide”)) AND (TS = (“Surface Properties” OR “Surface Contamination” OR “Surface Modification”)) AND (TS = (“Osseointegration” OR “Biocompatibility” OR “Biological Effects” OR “)) | 114 |
Study Author | Study Year | Study Type (Animal Model) | Number and Features of Animal Used | Dental Implant Number and Type; Location of Placement | Groups | SLA Technique Used | Residual Al | Biological Effects | Study Findings | Comments/Notes |
---|---|---|---|---|---|---|---|---|---|---|
Abdulla et al. [18] | 2024 | Experimental (Dogs) | 24 healthy, mature adult, local breed male dogs, aged 1–1.5 years and weighing 22 ± 3 kg | 72 commercially pure, standard screw-type Titanium dental implants; mandible | G1: SLA surface G2: 50 µm Al2O3-blasted G3: Laser-treated G4: Propolis-coated | Air-abraded with 50 μm Al2O3 particles for 15 s at 0.6 MPa, 6 bars of pressure | Present | Good bone response with sufficient new bone development along the implant surface. | Uniform and ongoing pattern of bone growth and many osteoblasts, with few osteocytes within lacunae in new bone trabeculae. | Al2O3 showed no negative effect on osseointegration. |
Gil et al. [19] | 2022 | Experimental (Minipig) | 20 twelve-year-old female minipigs | 240 commercially pure grade 3 titanium dental implants (3.8 mm-wide, 12 mm-long); mandible and maxilla | G1: As-received (CTR) G2: TiO2-blasted G3: Al2O3-blasted | G2–G3: Grit-blasted with 600-μm size particles and 0.25 MPa blast pressure. All samples AE with HCl/H2SO4 for 15 s | Present | The presence of residual blasting of Al2O3 and TiO2 did not affect the osseointegration of titanium dental implants. | Osseointegration of Al2O3-blasted implants is higher than the control and TiO2-blasted implants, with BIC values twice as high (63% vs. 38%) at 6 weeks follow-up. | Blasting with Al2O3 favors the osseointegration of titanium dental implants compared with TiO2. |
Gil et al. [20] | 2022 | Experimental (Minipig) | 8 twelve-year-old female minipigs | 110 cylindrical, commercially pure grade 3 titanium dental implants (3.8 mm-wide, 12 mm-long); mandible | G1: No blast G2: Al2O3-blasted G3: Al2O3-blasted and special cleaning | Shot-blasted with Al2O3 particles with a size range of 212–300 mm at a pressure of 2.5 MPa until saturation | Present and removed | Residual Al accelerated bone growth and reduced bacterial adhesion. | In vivo studies demonstrated the beneficial effects of residual Al on bone growth and bactericidal properties | Presence of residual blasting of Al2O3 favors the osseointegration of titanium dental implants. |
Ríos-Carrasco et al. [21] | 2021 | Experimental (Rabbit) | 6 New Zealand white rabbits of 6 months of age weighing 3 to 4 kg | 24 commercially pure titanium grade 4 dental implants, 4.0 mm-wide × 8.0 mm-long and a neck section of 1.5 mm in height; tibia | G1: Al2O3-blasted G2: Al2O3-blasted, and acid-etched | Shot-blasted with Al2O3 particles of 425 to 600 µm | Present | No negative impact on osseointegration. | The bone-to-implant contact ratio (BIC%) showed a similar tendency, with 55.18 ± 15.67 and 59.9 ± 13.15 for SB and SB + AE implants. | Both surfaces of implants studied showed high osseointegration. |
Gehrke et al. [22] | 2018 | Experimental (Rabbit) | 8 New Zealand white adult rabbits weighing approximately 4 kg | 48 cylindrical titanium dental implants; tibia | G1: Al2O3 microparticles G2: TiO2 microparticles | Sandblasting with Al2O3 and TiO2 | Present | No significant differences in osseointegration between Al2O3 and TiO2. | Histological analysis showed a complete bone organization and mineralization at 8 weeks in both groups. The BIC% did not show statistical differences. | Both Al2O3 and TiO2 can be used effectively for surface blasting. |
Yurttutan et al. [23] | 2018 | Experimental (Sheep) | 4 two-year-old female sheep, weighing 45 kg | 64 cylindrical titanium dental implants, 4.0 mm-wide and 10 mm-long; tibia | G1: Al2O3-blasted G2: TiO2-blasted G3: SiO2-blasted G4: Machined | Sand-blasted with Al2O3 particles of 180 to 200 µm | Present | Better osseointegration with implants blasted with Al2O3 particles. | Although there were no statistically significant differences between the groups, the implants sandblasted with Al2O3 showed a higher Implant Stability Quotient (ISQ) and removal torque value at the end of the 1st and 3rd months. | The results demonstrate that Al2O3 is superior to other sand particles. |
Rüger et al. [24] | 2010 | Experimental (Rabbit) | 38 adult female New Zealand white rabbits | Cylindrical implants of either commercial pure titanium (ISO5832-2) or Ti6Al7Nb (ISO5832-11), 10 mm, the outer diameter 5 mm, and the inner diameter 2 mm, with a threaded bore; distal femoral metaphysis | G1: 20 µm Al2O3 grit blasting G2: Al2O3 free (acid-etched) | Grit-blasting with 20 µm Al2O3, followed by a special cleaning procedure rinse in ammonium bifluoride and nitric acid (<1 min each) | Present and removed | Improved biocompatibility and increased bone–implant contact, and lower shear resistance. | Al2O3-free implants exhibited increased bone–implant contact but lower shear resistance. | Indicates that removing residual Al particles may enhance bone–implant contact. |
Piattelli et al. [15] | 2003 | Experimental (Rabbit) | 12 New Zealand white mature male rabbits | 24 threaded screw-shaped, machined grade 3 commercially pure titanium dental implants; tibia | G1: Al2O3-blasted G2: Saline-treated | Sandblasted with 100–120 µm Al2O3 particles at a 5 atm pressure for 1 min | Present | Newly formed bone was found in contact with the implant surface. Bone trabeculae were in close contact with the implant surface. Newly formed blood vessels were observed. Some osteoblasts were actively secreting osteoid matrix directly on the implant surface. | Found no statistically significant differences in bone–implant contact, number of multinucleated cells, and osteoclasts between groups. | Residual Al oxide particles on implant surface do not affect osseointegration. |
Mueller et al. [25] | 2003 | Experimental (Rabbit) | 27 female adult Chinchilla rabbits, strain CH bb-CH, body weight 3–4 kg | 63 commercially pure titanium cylinders (8 mm in length and 4 mm in diameter); distal femur epiphysis | G1: Untreated G2: 110 µm Al2O3-blasted G3: 50 µm bio-ceramic-blasted | Blasted with Al2O3 particles (carborundum) with a particle size of 110 mm | Present | No untoward or negative effects from Al ions found on implant surfaces. | A dense ring of bone was developed, similar to cortical bone regarding density and development of Haversian canals with all surfaces after 84 days. | The MBC showed a tendency for more bone after bio-ceramics were used as a blasting material, compared to Al2O3. |
Wennerberg et al. [26] | 1996 | Experimental (Rabbit) | 10 adult (9–11 months old) male New Zealand white rabbits | 60 screw-shaped, commercially pure titanium implants of length 6mm, diameter 3.75 mm, and pitch height 0.6 mm; tibia | G1: Machined surface G2: TiO2-blasted G3: 25 µm Al2O3-blasted G4: 75 µm Al2O3-blasted | Sandblasting with 25 µm and 75 µm Al2O3 particles | Present | No untoward or negative effects from Al ions found on implant surfaces. | Comparing implants blasted with 75 µm Al2O3 particles to as-machined implants, the blasted specimens exhibited a statistically significant higher bone-to-metal contact after 12 weeks in the rabbit bone. | Implants blasted with 75 µm Al2O3 particles showed better osseointegration than 25 µm particles. |
Study Author(s) | Year | Sequence Generation (Selection Bias) | Baseline Characteristics (Selection Bias) | Allocation Concealment (Selection Bias) | Random Housing (Performance Bias) | Blinding (Performance Bias) | Random Outcome Assessment (Detection Bias) | Blinding (Detection Bias) | Incomplete Outcome Data (Attrition Bias) | Selective Outcome Reporting (Reporting Bias) | Other Sources of Bias (Other) |
---|---|---|---|---|---|---|---|---|---|---|---|
Abdulla et al. [18] | 2024 | Low Risk | Low Risk | Unclear Risk | Low Risk | Unclear Risk | Low Risk | Low Risk | Low Risk | Low Risk | Low Risk |
Gil et al. [19] | 2022 | Low Risk | Low Risk | Unclear Risk | Low Risk | Unclear Risk | Low Risk | Unclear Risk | Low Risk | Low Risk | Low Risk |
Gil et al. [20] | 2022 | Low Risk | Low Risk | Unclear Risk | Low Risk | Unclear Risk | Low Risk | Unclear Risk | Low Risk | Low Risk | Low Risk |
Ríos-Carrasco et al. [21] | 2021 | Low Risk | Low Risk | Unclear Risk | Low Risk | Unclear Risk | Low Risk | Unclear Risk | Low Risk | Low Risk | Low Risk |
Gehrke et al. [22] | 2018 | Low Risk | Low Risk | Unclear Risk | Low Risk | Unclear Risk | Low Risk | Unclear Risk | Low Risk | Low Risk | Low Risk |
Yurttutan et al. [23] | 2018 | Low Risk | Low Risk | Unclear Risk | Unclear Risk | Unclear Risk | Low Risk | Unclear Risk | Low Risk | Low Risk | Low Risk |
Rüger et al. [24] | 2010 | Low Risk | Low Risk | Unclear Risk | Unclear Risk | Unclear Risk | Low Risk | Low Risk | Low Risk | Low Risk | Low Risk |
Piattelli et al. [15] | 2003 | Low Risk | Low Risk | Unclear Risk | Unclear Risk | Unclear Risk | Low Risk | Low Risk | Low Risk | Low Risk | Low Risk |
Mueller et al. [25] | 2003 | Low Risk | Low Risk | Unclear Risk | Unclear Risk | Unclear Risk | Low Risk | Low Risk | Low Risk | Low Risk | Low Risk |
Wennerberg et al. [26] | 1996 | Low Risk | Low Risk | Unclear Risk | Low Risk | Low Risk | Low Risk | Low Risk | Low Risk | Low Risk | Low Risk |
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Panda, S.; Tumedei, M.; Panda, S.; Goker, F.; Depalma, C.M.; Pande, T.; Del Fabbro, M. The Biological Impact of Residual Aluminum Particles on Sand-Blasted Dental Implant Surfaces: A Systematic Review of Animal Studies. Appl. Sci. 2024, 14, 7745. https://doi.org/10.3390/app14177745
Panda S, Tumedei M, Panda S, Goker F, Depalma CM, Pande T, Del Fabbro M. The Biological Impact of Residual Aluminum Particles on Sand-Blasted Dental Implant Surfaces: A Systematic Review of Animal Studies. Applied Sciences. 2024; 14(17):7745. https://doi.org/10.3390/app14177745
Chicago/Turabian StylePanda, Sourav, Margherita Tumedei, Sital Panda, Funda Goker, Cristina Maria Depalma, Tejas Pande, and Massimo Del Fabbro. 2024. "The Biological Impact of Residual Aluminum Particles on Sand-Blasted Dental Implant Surfaces: A Systematic Review of Animal Studies" Applied Sciences 14, no. 17: 7745. https://doi.org/10.3390/app14177745