The effect of surgicalinsertion on dental implantsurface topography
Surface topography is currently considered one of the most importantsurface properties regarding the biological response. Accordingly, anintense amount of implant research has been focused on the developmentof new surface treatments to increase surface roughness, aiming to enhance
the biological response and ultimately, the osteointegration. However,
the higher peaks and features of the enhanced roughness may break anddetach or be modified during the insertion procedure into bone. Therefore,
an important aspect to consider, though often overlooked, is whether theincreasingly complex surface features found on modern dental implants areretained after insertion.
The aim of this research was to investigate the impact of the insertion
procedure on the surface topography of dental implants. To achieve this,
it is necessary to evaluate if the surgical procedure degrades the enhanced
surface roughness by measuring and comparing the surface topographyboth before and after insertion exactly at the same locations.
The present paper is a part of a research1,2 carried out by Dr. Alaitz Zabala, Dr
Wilson Tato, Dr. Andrea Aginagalde and Dr. Iñigo Llavori.

CASE STUDY THE EFFECT OF SURGICAL INSERTION ON DENTAL IMPLANT SURFACE TOPOGRAPHY

University of Mondragon(Surface Technology Group)
Located in the Basque Country(Spain), the mission of theSurface Technology Group of
this university is focused on thecomponent surface analysis
and development with the aimof functional optimization. To
that end, the research is mainly
focused on advanced surface
metrology studies, on the effect ofsurface topography on functionalbehavior (tribology, corrosion,fatigue, fretting, and biologicalresponse among others) using
both; experimental and numericalapproaches.

1

■ Measurements
Wennerberg et al.3 took the first steps in measurements’ standardizationsuggesting some guidelines for dental implant characterization: threesamples in a batch must be evaluated, three dimensional measurements
must be made at three evaluation areas (tops, flanks and valleys), the filter
size must be specified, and at least one of each height, spatial, and hybrid
parameters should be presented. In addition, Wennerberg et al. claimed
that Confocal profilometers and Interferometers are the only acceptable
methods to evaluate densely threaded oral implant designs. This is one ofthe main reasons why the commercial 3D optical profilometer Plµ (formerversion of S neox, Sensofar Metrology, Spain) was chosen to carry out thiswork. This unique optical profilometer is the only one in the market that
includes Confocal, Interferometry (Phase Shifting and Coherence Scanning
Interferometry) and Focus Variation techniques embedded into the same
optical instrument. This feature allows for quickly evaluating dental implants
with different optical techniques. Many international dental research labs
have used Sensofar’s equipment for dental implants surface characterization,
validating the technology and making it one of the gold standards for thispurpose.4–12
In our study dental implants were measured with confocal at four different
locations (Fig. 1), both before and after insertion in cow rib bone (whichmimics human bone, Fig. 2).

Figure [1].
Denominationof the different
evaluation sites
and profile
examples

NECK

2

VALLEYFLANKTOP

CASE STUDY THE EFFECT OF SURGICAL INSERTION ON DENTAL IMPLANT SURFACE TOPOGRAPHY				(a)(b)

Figure [2].
Insertion procedure in fresh caw rib bone under standard procedures.
(a): insertion process;(b): non traumatic implant retrieval by separating the two previously generated bone block halves.

Due to the complex geometry of threaded dental implants, the measurementof different locations of the implants and the location of the same regionboth before and after insertion present a challenge.
Different locations were correctly positioned by means of an ad-hoc
developed dental implant handling and positioning device with 3 degrees
of freedom (Fig. 3).

(a)

(b)

Figure [3].
Dental implant handling and positioning device for correct positioningof implants.
(a): measurement of the top site;(b): measurement of the flank site;(c)(c): both measurements can be done by a specific rotational system too (i.e. S neox Five Axis)

However, the most advanced Sensofar’s system includes a rotational module(i.e., S neox Five Axis) that enables an automated full three-dimensionalsurface characterization.
Measurements were acquired using a 100X SLWD magnification objective inorder to acquire all topographical features in detail. The measurements werepost-processed by means of the metrology software SensoMAP (DigitalCASE STUDY THE EFFECT OF SURGICAL INSERTION ON DENTAL IMPLANT SURFACE TOPOGRAPHY3Surf ) in order to remove form (second order polynomial fitting), noise(Gaussian filter cut-off 0.36 µm) and waviness (Robust Gaussian filter cutoff 50 µm). These values were considered optimal for this application given
previous studies.1 Topographical parameters from ISO 25178-2 belonging
to height, spatial, hybrid and functional families were calculated in order tofully characterize the surface properties.
Fig. 4 shows axonometric representative projections of the measurements
taken at the same regions before and after insertion for the acid etched
implants. The sites that showed statistically significant topographicalparameter variations (p<0.05) are marked with *. It can be noted that thesharp peaks initially present became less prominent or had completely gone
after insertion in all the sites under study except the neck.		

Figure [4]. Representative axonometric projections of the measurements of an acid etcheddental implant at the four evaluation sites both before and after insertion. Those sites presenting
statistically significant topographical parameter variations are marked with*.

Figure [5]. Different views fromthe measurement profile process

4

CASE STUDY THE EFFECT OF SURGICAL INSERTION ON DENTAL IMPLANT SURFACE TOPOGRAPHY

■ Conclusions
Confocal technology has proven to be an effective technique to investigate
and characterize surface topography and the damage generated in modern
dental implant surfaces after the insertion into bone. This non-destructive
measuring technique allows characterizing different locations of the complex
threated dental implants with high resolution. Qualitative and quantitative
analysis were done to evaluate the surface modifications. The following main
points can be concluded from the various components of this study:•Surface damage varied at different evaluation sites for each implantsystem (neck, top, valley and flank) and also along the implant withineach site.

•The developed interfacial ratio (Sdr) variation correlated positively with thematerial volume variation (Vm) and is considered to be the best damageindicator.

•The use of functional volume parameters of ISO 25178 standard issuggested rather than the Rk family parameters defined in the European
report EUR 15178N due to the higher sensitivity encountered.

•The 3D optical profilometer S neox (Sensofar, Spain) has been shown to be
an accurate tool to investigate the surface topography of dental implants
before and after insertion into bone. More advanced tools such as theS neox Five Axis, would not only enable faster and more automated highresolution measurements, but also the 3D reconstruction of the complete
dental implant’s shape, which can be of interest for wear analyses orquality control in further studies.

■ References
1.

Zabala-Eguren, A. The use of 3D surface topography analysis techniques to analyseof surface characterization techniques to study covalent grafting of a biopolymer totitanium implant and its acidic resistance. Appl. Surf. Sci. 327, 296–306 (2015).
7.

and predict the alteration of endosseous titanium dental implants generated during
the surgical insertion. (Mondragon Unibertsitatea, 2015).
2.

of different microroughness. Dent. Mater. 32, 1374–1384 (2016).
8.

Zabala, A., Blunt, L., Tejero, R., Llavori, I., Aginagalde, A. and Tato, W. Quantification

3.

manufactured Ti6Al4V. Biotribology 11, 60–68 (2017).
9.

fiber-reinforced screw for implant-abutment connection. Dent. Mater. 34, 1585–1595

Wennerberg, A. & Albrektsson, T. Suggested guidelines for the topographic(2018).
10.

Walter, M. et al. Bioactive implant surface with electrochemically bound doxycycline
promotes bone formation markers in vitro and in vivo. Dent. Mater. 30, 200–214

11.

6.

Pierre, C., Bertrand, G., Rey, C., Benhamou, O. & Combes, C. Calcium phosphate coatings
elaborated by the soaking process on titanium dental implants: Surface preparation,Frank, M. et al. Polarization of modified titanium and titanium–zirconium creates
nano-structures while hydride formation is modulated. Appl. Surf. Sci. 282, 7–16

Medvecky, L. et al. Effect of tetracalcium phosphate/monetite toothpaste on dentin
remineralization and tubule occlusion in vitro. Dent. Mater. 34, 442–451 (2018).

(2014).
5.

Spies, B. et al. Stability and aging resistance of a zirconia oral implant using a carbon

672X/ab61e5.

evaluation of implant surfaces. Int. J. Oral Maxillofac. Implants 15, 331–44 (2000).
4.

Bertolini, R., Bruschi, S., Ghiotti, A., Pezzato, L. & Dabalà, M. Influence of the machining
cooling strategies on the dental tribocorrosion behaviour of wrought and additiveof dental implant surface wear and topographical modification generated during
insertion,. Surf. Topogr. Metrol. Prop., 8, no. 1, p. 015002 (2020), doi: 10.1088/2051-

Andrukhov, O. et al. Proliferation, behavior, and differentiation of osteoblasts on surfaces

processing and physical–chemical characterization. Dent. Mater. 35, e25–e35 (2019).
12.

Aguirrebeitia, J., Müftü, S., Abasolo, M. & Vallejo, J. Experimental study of the removal(2013).

force in tapered implant-abutment interfaces: A pilot study. J. Prosthet. Dent. 111,

D’Almeida, M., Amalric, J., Brunon, C., Grosgogeat, B. & Toury, B. Relevant insight

293–300 (2014).

CASE STUDY THE EFFECT OF SURGICAL INSERTION ON DENTAL IMPLANT SURFACE TOPOGRAPHY

5SENSOFAR is a leading-edge technology
company that has the highest quality standards
within the field of surface metrology
Sensofar Metrology provides high-accuracy optical profilers
based on confocal, interferometry and focus variation techniques,from standard setups for R&D and quality inspection laboratories
to complete non-contact metrology solutions for in-line
production processes. Sensofar Group is headquartered inBarcelona, also known as a technology and innovation hub inEurope. The Group is represented in over 30 countries througha global network of partners and has its own offices in Asia,
Germany and the United States.
HEADQUARTERS

SENSOFAR METROLOGY | BARCELONA (Spain) | T. +34 93 700 14 92 | info@sensofar.com

SENSOFAR ASIA | SHANGHAI (China) | T. +86 021 51602735 | info.asia@sensofar.com
SENSOFAR GERMANY | MUNICH (Germany) | T. +49 151 14304168 | info.germany@sensofar.com
SENSOFAR USA | NEWINGTON (USA) | T. +1 617 678 4185 | info.usa@sensofar.com

sensofar.com

CS00-05B-EN-Uni Mondragon

SALES OFFICES