In vivo biofunctionalization of titanium patient-specific implants with nano hydroxyapatite and other nano calcium phosphate coatings: A systematic review.

OBJECTIVE: To delineate the best procedures for increasing osseointegration in cranio-maxillo-facial surgery using nano-sized calcium phosphate coatings on titanium patient specific implants. MATERIALS AND METHODS: A multi-database single-reviewer systematic literature review was conducted. RESULTS: Twenty-eight papers consisting of twenty-five animal studies and three human studies met the selection criteria. The results of existing literature suggest that titanium implants coated with nano calcium phosphate and hydroxyapatite improves osseointegration and implant fixation. However, not all coating techniques enhance biofunctionalization. Factors including implant microroughness, coating thickness, calcium phosphate solubility, and nanotopography contribute significantly to biofunctionalization. Nonetheless, additional data derived from clinical studies are needed to support this statement, as well as the possible influence of routine autoclaving procedures.