Nature of Metallic Implant Surfaces and the Importance of their Preparation

SUMMARY In addition to implant design and fabrication, surgical techniques, case selection, periodontal considerations, prosthetic devices, and occlusal forces, the host response can be adversely affected by organic and inorganic contaminants on the implant surface at the time of implantation. These may be caused by inadequate implant preparation, handling, cleaning, or sterilization procedures. Therefore, it is necessary to investigate the effects of cleaning and sterilization methods prior to device implantation to understand the events of ion exchange, mineralization, wound healing, and bioadhesion. The most common source of inorganic and organic contaminants on implant devices is conventional sterilization procedures. It should be noted that conventional processes such as steam autoclaving, ethylene oxide gas sterilization, glass bead immersion, and glutaraldehyde and alcohol soaking all leave surface residues on the implant device. Other techniques, such as UV light treatment or radiofrequency glow discharge treatment, offer both sterilization and cleaning of surface contaminants with resultant surface activation and increased bioadhesion at implant surfaces.