Dental implant success relies on the conjuntion of optimal esthetic and mechanical parameters. These, in turn, depend on the characteristics and stability of the bond created between the implant and its surrounding bone. More than 30 years ago, Albrektsson et al. described the six factors that influence the interfacial bone-implant bonding: surgical technique; host bed; implant design; implant surface; material biocompatibility; and loading conditions. Thereafter, the standards of each factor have evolved, but the relevance of each of the six points persists.
The implant itself determines three of these factors: design; surface; and material biocompatibility. The rate and quality of osseointegration is directly related to these properties. Implant topography can be further characterized as macro-, micro- and nanoroughness according to the scale of evaluation. The characteristics of the implant at each of these levels have specific consequences on wound healing and osseointegration.
This chapter will review the current scientific literature on implant topography and offer a critical analysis of the influence of these factors on peri-implant bone formation and maintenance. The following topics will be addressed:
1.2 Implant design
1.2.1 Background
1.2.2 Is there an ideal implant shape?
1.2.3 Is implant morphology relevant in implant performance?
1.2.4 How does the implant’s crest module modulate marginal bone resorption?
1.2.5 Conclusions
1.3 Implant surface
1.3.1 Background
1.3.2 How should an implant surface be characterized?
1.3.3 What surface treatments are available?
1.3.4 Are modern surfaces better than their predecessors?
1.3.5 What can we expect from the future?
1.3.6 Conclusions
