Dental implants are commonly used in dental therapeutics, but dental practitioners only have limited information about the characteristics of the implant materials they take the responsibility to place in their patients. Manufacturers, scientists and administrations are also lacking of a consensual and clear method and terminology to characterize and control implant surfaces. The objective of this series of 5 articles is to define and describe the Implant Surface Identification Standard (ISIS) system for the chemical and morphological characterization of dental implant surfaces, and to use it to characterize and establish the respective Identification (ID) Card and code of 62 implant surfaces available on the market.
In this first part, the current version of the ISIS system and methodology is described and discussed. Using standardized protocols of analysis and terminology, each osseointegrated implant surface can be defined using a standardized characterization code. First the ISIS codification system describes the surface chemical composition: the core material (titanium grades, zirconia, hydroxy-apatite) and the chemical modification (impregnation, coating, pollution). The system then defines the surface morphology (topography, structures) at the microscale (microroughness, micropores, microparticles) and nanoscale (nanoroughness, nanopatterning, nanotubes, nanoparticles, nanosmooth), and its global architecture (homogeneity, cracks, fractal architecture). This standardized characterization, classification and codification system allows to clarify the identity of each surface and to easily sort out their differences, to control implant production and to facilitate communication. Therefore it offers a global solution for the manufacturers, scientists, implant users, administrative authorities and the interactions of these 4 actors, and it could be suggested as the basis of an ISO standard in the future.
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