Abstract

The main scope of this paper is to make a critical review on the effects of dental implants surface micro-roughness on osseointegration using existing in vivo and in vitro studies in the literature. The osseointegration, formation of bone around a dental implant, is considered as a pivotal factor in determining clinical success of dental implantation. Among various factors, surface roughness of dental implants, including micro-roughness, is one of the most crucial factors affecting the osseointegration process. Surface micro-roughness of dental implants regulates the cellular behavior at the bone-implant interface, directly affecting the differentiation to osteoblasts, the bone forming cells, and also facilitates proteins adsorption in the early stages of osseointegration, which encourages cellular attachment to implant surface. This paper first reviews key roughness parameters, which can be used to characterize the roughness features of the implant surface. Then, surface modification techniques, which enhance the physical and chemical properties of implant surface, and their effects on micro-morphology of surface will be covered. Additionally, the effects of surface modification techniques on osseointegration are also discussed.  Despite numerous studies investigating effects of dental implants surface roughness on osseointegration, yet there is no consensus on optimal values for most roughness parameters, which can offer maximum osseointegration. In this work, a review was made on in-vivo and in-vitro studies, which examined the relationship between surface roughness and osseointegration. Overall, this paper highlights the important role of surface roughness on osseointegration process, and summarizes the optimal ranges for each roughness parameter, based on the current literature. Last, a summary of some open questions related to the key roughness parameters, also on the process of osseointegration between bone and dental implant is presented.