Osteogenic Differentiation on Nonthermal Atmospheric Plasma-Treated versus SLActive® Titanium and Titanium–Zirconium Implants: An In Vitro Comparative Study

OpenAlex English

OBJECTIVES: Although implant therapy with sandblasted large grit acid-etched (SLA) titanium (Ti) and titanium-zirconium alloy (TiZr) has been a reliable option in edentulous cases, the conventional 3-month healing period remains relatively long, encouraging efforts to further shorten healing time and enhance early osseointegration. Significant progress in Ti and TiZr implant surface properties has been made to overcome the critical challenges of implant dentistry. Although both nonthermal atmospheric plasma (NTAP) treated and SLActive® implants can provide super-hydrophilic surfaces and increase osteoblast adhesion and differentiation on titanium implants, the comparison of NTAP-treated Ti and TiZr SLA® and Ti and TiZr SLActive® surfaces on osteogenic differentiation has not been fully studied yet. The study aims to compare osteogenic differentiation in vitro on NTAP-treated Ti and TiZr SLA® and Ti and TiZr SLActive®. MATERIAL AND METHODS: Ti and TiZr SLA® were treated with a plasma source to convert hydrophobic Ti and TiZr SLA® surfaces into hydrophilic state and compared the osteogenic differentiation in vitro with Ti and TiZr SLA and SLActive® surfaces. Contact angle measurements, scanning electron microscopy (SEM), and surface roughness were performed to physical characterization of implants. Then, osteogenic differentiation of hBMSCs on the implants was evaluated for 21 days by calcium assay, alkaline phosphatase assay, DNA content quantification kit, and mRNA expression with Quantitative real-time PCR analysis. RESULTS: NTAP treatment increased the wettability of all SLA implants. Ti and TiZr NTAP-treated implants had higher osteoblastic proliferation and differentiation compared with untreated ones. SLActive implants showed maximum osteogenic differentiation. In terms of material difference, TiZr SLActive discs had higher differentiation compared to SLActive discs. CONCLUSIONS: NTAP treatment was found to be effective in increasing wettability. The accelerated osteoblastic difference was seen in NTAP-treated samples compared to SLA samples. Although nonthermal atmospheric plasma (NTAP) treatment effectively improved the hydrophilicity of SLA surfaces and accelerated osteogenic differentiation, the SLActive® surface-particularly TiZr SLActive®-demonstrated the most pronounced effect in promoting osteogenesis in this in vitro study.