Nanotechnology and tissue engineering for customized low-cost zirconia implants

Dental implants can be used to restore lost dentition, but biocompatibility and choice of materials are still of concern.

Objective: To fabricate a customized zirconia implant using CAD/CAM systems and to enhance their osseo-integration using principles of nano-technology, genetics, and tissue engineering.

Methods: 'Selective infiltration etching' technique was performed on CAD/CAM produced zirconia implants to optimize their surface architecture on nano-level. Human osseo- and fibroblast cells collected from 3 patients were cultured on the surface of the implants. Cell count, DNA, protein assay, alkaline phosphatase activity were used to evaluate cell performance. Mechanisms of cell attachment were evaluated using SEM. Titanium implants served as control. Parameters of 'selective infiltration etching' were optimized to enhance soft tissue attachment in the collar region and hard tissue integration in the implant body region by means of the pocket depth.

Results: 'Selective infiltration etched' zirconia implants performed better than the control. SEM evaluation revealed the correlation between surface nano-architecture and mechanisms of cell attachment; focal attachment, hemi-desmosomes, and membrane fusion.

Conclusion: The mechanism of tissue-integration is influenced by the nano-architecture of the implant surface. The performance of 'Selective infiltration etched' zirconia implants could open the door for “in-house” production of a customized low-cost implant.