Early Loading of Titanium Dental Implants with Hydroxyl Ion Modified Surface: A 12-Month Prospective Clinical Trial  
[PERSON]  
1 Oral Surgery Department, Wroclaw Medical University, Krakowska st. 26, 54-207 Wroclaw, Poland;  
[EMAIL_ADDRESS] (M.K. ); [EMAIL_ADDRESS] (M.D. );  
[EMAIL_ADDRESS] (A.B. ); [EMAIL_ADDRESS] (P.K.-R.)  
2 Digital Denistry Laboratory, Faculty of Medicine and Dentistry, Department of Conservative Dentistry with Endodontics, Wroclaw Medical University, Krakowska st. 26, 54-207 Wroclaw, Poland;  
[EMAIL_ADDRESS] (Correspondence: [EMAIL_ADDRESS] (Correspondence: [EMAIL_ADDRESS] (1))  
[PERSON]  
1 Oral Surgery Department, Wroclaw Medical University, Krakowska st. 26, 54-207 Wroclaw, Poland;  
[EMAIL_ADDRESS] (M.K. ); [EMAIL_ADDRESS] (M.D. );  
[EMAIL_ADDRESS] (A.B. ); [EMAIL_ADDRESS] (P.K.-R.)  
2 Digital Denistry Laboratory, Faculty of Medicine and Dentistry, Department of Conservative Dentistry with Endodontics, Wroclaw Medical University, Krakowska st. 26, 54-207 Wroclaw, Poland;  
[EMAIL_ADDRESS] (Correspondence: [EMAIL_ADDRESS] (Correspondence: [EMAIL_ADDRESS] (1))  
[PERSON]  
2 Digital Denistry Laboratory, Faculty of Medicine and Dentistry, Department of Conservative Dentistry with Endodontics, Wroclaw Medical University, Krakowska st. 26, 54-207 Wroclaw, Poland;  
[EMAIL_ADDRESS] (Correspondence: [EMAIL_ADDRESS] (Correspondence: jakub. is the method of implant bed preparation [5]. The final factor affecting primary stability are the characteristics of an implant, which include both the macroscopic and microscopic features of the implant surface [6]. The macroscopic features of an implant relate to aspects such as the dimensions, shape, diameter and thread pitch of the implant. The microscopic features are the overall characteristics of the surface, primarily including the grade of the roughness of the surface [1; 2; 3; 6]. In the context of osteointegration, much attention has been paid in recent years to the physical and chemical aspects of dental implant surfaces. These include electrochemical potential, surface wettability, thickness of the titanium dioxide (TiO\({}_{2}\)) layer, ion adhesion, active peptides, growth factors, and antibiotics. Currently, work is still underway to develop a type of surface that would allow for even faster loading of an implant even when primary stability is low [7; 8; 9]. One such potential method is the chemical modification of the surface using hydroxyl ion. With such a modification, the titanium surface of an implant has a negative electrochemical potential. The negative potential determines the improvement of the osteointegration process at all stages, starting from better stability of blood clot and adhesion of Ca++ ions in the first hours after the loading of a dental implant, through to a better adhesion of proteins (fibronectin, osteoclastcin) and the cells that determine the process of osteointegration (mesenchymal stem cells (MSC)) in the later stages of the process [10; 11]. In the case of implant treatment within the aesthetic zone, a temporary restoration, usually a removable one, is needed. It causes many difficulties for the patient. Therefore, the methods for shortening the healing period and loading an implant as early as possible are constantly being sought after. The first reports claiming a high rate of success concerning early loading of an implant date back to the 1990s and refer to the Branemark implant system [9; 10]. For decades, implant loading after six weeks was considered an early loading. However, it seems that the key period for the process of osteointegration and secondary stability is in the third and fourth week. During that time, the process of mineralization of the primary osseous tissue takes place, and thus, the bone tissue that surrounds an implant achieves the mechanical values that enable loading. Therefore, it seems reasonable to load an implant even faster, i.e., after 3-4 weeks of healing [9; 10; 11; 12; 13; 14; 15].