Development of innovative zirconia implants from novel materials, surface modification to biological responses

Zirconia ceramics are rapidly becoming the material of choice for metal-free dental implants, because of their superior mechanical characteristics, excellent biocompatibility with low bacterial plaque affinity and natural aesthetics. The long-term clinical success of dental implants largely  depends on their osseointegration potential, which is highly influenced by surface chemistry and topography. The osseointegration potential of zirconia, however, is suboptimal, especially since high failure rates and peri-implant crestal bone loss have recently been reported in a number of human trials. Surface modification by acid etching, sandblasting, injection molding, laser micro-patterning and plasma nano-coatings have been suggested to tailor the implant surface for improved cell attachment, proliferation and differentiation during bone healing. Yet, due to a lack of  relevant 3D cell-culture models and long-term in-vivo studies, the nature of cell-zirconia surface interactions is insufficiently known. We aim to address the knowledge gaps that exist between material design and manufacturing of zirconia and its final clinical application as dental implant.  Using an interdisciplinary research approach, encompassing  thorough surface characterization along with novel 3D cell culturing and animal experimentation, the biological response to zirconia implant-surface modifications will be investigated, particularly focusing on the formation of the  tissue-implant interface.