Clinical evidence and Science 5 Use and development of titanium in implant dentistry In the 1950s, Brånemark et al. discovered that titanium, experimentally implanted into rabbits, was treated as endogenous tissue by the surrounding bone. Further investigations confirmed this phenomenon which was a landmark in dental implantology. The inception of osseointegration as a concept was introduced (1). Commercially pure titanium (or CPTi) with its high mechanical strength combined with excellent corrosion resistance is still the material of choice for endosseous dental implants today. It is recognized as an excellent implant material with high biocompatibility and has been the prime material for clinical use in implant dentistry for more than 40 years. Since then, the morphology and topography of the implant surface has been continuously refined for optimal osseointegration. In the early 90s the first studies on sandblasted, acid etched titanium surfaces showed superior bone-to-implant contact compared to plasma-sprayed and machined titanium surfaces (2). In addition, micro-rough surfaces demonstrated accelerated osseointegrative properties. Sandblasting followed by acid etching may be regarded as the gold standard technique to create micro-rough surfaces (3). The Promote® implant surface The Promote® Surface, a sandblasted and acid et- ched surface, has been developed and applied to Camlog implants for more than 20 years (Fig. 2). It is based on current scientific knowledge and represents the state-of-the-art favoring rapid osseointegration. Results from cell cultures, osteohistology and in pull-out tests as well as clinical studies clearly illustrate this (Fig. 3) (4). A state-of-the-art surface applied to titanium implants by sandblasting and acid etching leading to a positive clinical effect on bone growth and related osseointegration. THE PROMOTE® IMPLANT SURFACE Fig. 2_Scanning electron microscope (SEM) image of the Promote® Surface 10 my
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