The dental implant surface: a review of the past, present and future

PURPOSE: The review provides an in-depth analysis of various factors that affect the long-term success of implants and scrutinizes all available techniques for dental implant modifications, along with their advantages and limitations. Along with established and proposed strategies, newer trends such as responsive coatings, 'omics' and AI-based possibilities for translating research into clinical settings are discussed. METHODS: The available scientific literature on dental implants, causes for their failures, and possible surface modification techniques was collected and analyzed. Strategies to prevent implant failures are presented as a comprehensive, structured review. RESULTS: A literature review of scientific research papers published over the last decade clearly indicates that surface modification of dental implants is critical for ensuring long-term success. Strategies aimed at surface changes consider the intrinsic antibacterial activity, surface texture, and geometry of the implant material. In both healthy and compromised patients, bio-functionalized surfaces can improve osseointegration and reduce peri-implantitis, boosting the success of dental implants. CONCLUSIONS: Dental implants, while promising, face hurdles that hinder their long-term success. Modifying implants through physical, chemical, or mechanical methods could potentially address these challenges. These techniques would require clinical validation before being fully integrated into clinical practice. Moreover, crucial factors such as immune response and in vivo testing are often overlooked.