Systematic Review on Hydroxyapatite and Chitosan Combination-coated Titanium Implants on Osseointegration
Rajeshkumar Shanmugam, Lakshmi Thangavelu, Revathi Duraisamy, Dhanraj Ganapathy
Abstract
combination with antibacterial nanoparticles have been performed on Ti alloys. [4]5][6][7] Recently, various natural and synthetic polymers that IntroductIon Titanium (Ti) and Ti alloys, with their good biocompatibility, high corrosion resistance, increased ductility, and strength, have been widely used for dental implantation. 1Osseointegration, a key success in dental implantation, occurs when metals contact living bone tissue without forming any fibrous capsule.A thin oxide layer (20-50 nm) between living bone tissue and Ti alloy, into which growth factors are released, is vital in initiating bone formation. 2Formation of this thin layer depends on the cascade of four processes such as hemostasis, inflammation, proliferation, and bone remodeling. 3However, the degree of implantation confides in the characteristics of alloy, surgical technique, bone quality/quantity, and occlusal loading.Two types of Ti alloys, namely cpTi and Ti-6Al-4V, with high modulus of elasticity (103-110GPa) compared to cortical bone (12.6-21GPa) and cancellous bone (0.5-3.5GPa) share the stress transmitted to bone tissue enhancing osseointegration. 3This high elastic moduli induces bone resorption, causing alveolar bone remodeling due to insufficient stress stimulation on bone tissue, leading to implant failure.Also, Ti alloys are highly susceptible to bacterial growth due to their reduced osteoconductive and osteoinductive property.To combat the abovementioned disadvantages, various surface modifications, biofunctionalization, and texture fabrication in