TiUnite®
TiUnite® is a highly crystalline and phosphate enriched titanium oxide characterized by a
microstructured surface with open pores in the low micrometer range1. The TiUnite® implant
surface has repeatedly proven to give an enhanced bone response compared to machined
implant surfaces2-9. Nobel Biocare has received FDA clearance to claim a more rapid bone
formation and greater amount of bone in contact with the TiUnite® surface during healing.
The enhanced bone response to TiUnite® results in faster and stronger osseointegration and,
thereby, better maintenance of the implant stability compared to machined titanium implants.
When placed in soft bone and immediately loaded, the enhanced osseointegration of Nobel
Biocare TiUnite® implants results in higher success rates compared to machined implants.
These claims are supported by extensive research2, 10-31.
In addition to the publications supporting the FDA-cleared claims for the TiUnite® implant
surface, more than fifty references are available, which cover the use of TiUnite® implants in
various clinical and preclinical situations, using different types of protocols, and with various
follow-up times32-84.
References
1.
Hall J, Lausmaa J. Properties of a new porous oxide surface on titanium implants. Appl Osseointegration Res
2000;1:5-8.
2.
Albrektsson T, Johansson C, Lundgren AK, Sul Y, Gottlow J. Experimental studies on oxidized implants. A
histomorphometrical and biomechanical analysis. Appl Osseointegration Res 2000;1:21-24.
3.
Degidi M, Petrone G Iezzi G, Piatelli A. Histologic evalaution of a human immediately loaded titanium implant
with a porous anodized surface. Clin Implant Dent Relat Res 2002;4:110-114.
4.
Huang YH, Xiropaidis AV, Sorensen RG, Albandar JM, Hall J, Wikesjö UME. Bone formation at titanium porous
oxide (TiUnite) oral implants in type IV bone. Clin Oral Impl Res 2005;16:105-111.
5.
Ivanoff C-J, Widmark G, Johansson C, Wennerberg A. Histologic evaluation of bone response to oxidized and turned
titanium micro-implants in human jawbone. Int J Oral Maxillofac Implants 2003;3:341-348.
6.
Rocci A, Martignoni M, Burgos P, Gottlow J, Sennerby L. Histology of retrieved immediately and early loaded
oxidized implants. Light microscopic observations after 5 to 9 months of loading in the posterior mandible of 5 cases.
Clin Implant Dent Relat Res 2003;12 ( Suppl 1):88-98.
7.
Salata LA, Burgos PM, Rasmusson L, Novaes AB, Papalexiou V, Dahlin C, Sennerby L. Osseointegration of
oxidized and turned implants in circumferential bone defects with and without adjunctive therapies: an experimental
study on BMP-2 and autogenous bone graft in the dog mandible. Int J Oral Maxillofac Surg. 2007;36(1):62-71.
8.
Schüpbach P, Glauser R, Rocci A, Martignoni M, Sennerby L, Lundgren AK, Gottlow J. The human bone-oxidized
titanium implant interface: a microscopic, scanning electron microscopic, back-scatter electron microscopic, and
energy-dispersive X-ray study of clinically retrieved implants. Clin Implant Dent Relat Res 2005;7 ( Suppl 1):3643.
9.
Zechner W, Tangl S, Furst G, Tepper G, Thams U, Mailath G, Watzek G. Osseous healing characteristics of three
different implant types. A histologic and histomorphometric study in mini-pigs. Clin Oral Implants Res
2003;14:150-157.
10. Balshi SF, Wolfinger GJ, Balshi TJ. A prospective study of immediate functional loading following the Teeth in a
Day protocol: a case series of 55 consecutive edentulous maxillas. Clin Implant Relat Res 2005;7:24-31.
11. Brechter M, Nilson H, Lundgren S. Oxidized titanium implants in reconstructive jaw surgery. Clin Implant Dent
Relat Res 2005;7 ( Suppl 1):83-87.
GEN 62713
April 2007
12. Calandriello R, Tomatis M. Immediate function of single implants using Brånemark System. Prospective one year
report of final restorations. Appl Osseointegration Res 2004;4:32-40.
13. Calandriello R, Tomatis M. Simplified treatment of the atrophic posterior maxilla via immediate/early function and
tilted implants: a prospective 1-year clinical study. Clin Implant Dent RelatRes 2005;7 ( Suppl 1):1-12.
14. Calandriello R, Tomatis M, Vallone R, Rangert B, Gottlow J. Immediate occlusal loading of single molars using
Brånemark System Wide Platform TiUnite implants: An interim report of a prospective, open-ended clinical multicenter study. Clin Implant Relat Res 2003;5 ( Suppl 1):74-80.
15. Chiapasco M, Gatti C. Immediate loading of dental implants placed in revascularized fibula free flaps: a clinical
report on 2 consecutive patients. Int J Oral Maxillofac Implants 2004;19;906-912.
16. da Cunha HA, Francischone CE, Filho HN, de Oliveira RC. A comparison between cutting torque and resonance
frequency in the assessment of primary stability and final toque capacity of standard and TiUnite single-tooth
implants under immediate load. Int J Oral Maxillofac Implants 2004;19:578-585.
17. Glauser R, Portmann M, Ruhstaller P, Lundgren AK, Hämmerle C, Gottlow J. Stability measurements of
immediately loaded machined and oxidized implants in the posterior maxilla. A comparative clinical study using
resonance frequency analysis. Appl Osseontegration Res 2001;2:27-29.
18. Glauser R, Ruhstaller P, Windisch S, Zembic A, Lundgren AK, Gottlow J, Hämmerle CHF. Immediate occlusal
loading of Brånemark System TiUnite implants placed in predominanatly soft bone: 4-year results of a prospective
clinical study. Clin Implant Dent Relat Res 2005;7 ( Suppl1):52-59.
19. Glauser R, Zembic A, Ruhstaller P, Windisch S. Five-year results of implants with an oxidized surface placed
predominantly in soft quality bone and subjected to immediate occlusal loading. J Prosthet Dent.
2007;97(suppl):S59-S68.
20. Henry P, Tan A, Allan B, Hall J, Johansson C. Removal toque comparison of TiUnite and turned implants in the
Greyhound dog mandible. Appl Osseointegration Res 2000;1:15-17.
21. Maló P, Rangert B, Nobre M. All-on-4 immediate-function concept with Brånemark System implants for completely
edentulous maxillae: a 1-year retrospective clinical study. Clin Implant Relat Res 2005;7 ( Suppl 1):88-94.
22. Olsson M, Urde G, Andersen JB, Sennerby L. Early loading of maxillary fixed cross-arch dental prostheses suppoted
by six or eight oxidized titanium implants: Results after 1 year of loading, case series. Clin Implant Relat Res 2003;5
( Suppl 1):81-87.
23. Renouard F, Nisand D. Short implants in severely resorbed maxilla: a 2-year retrospective clinical study. Clin
Implant Relat Res 2005;7 ( Suppl 1):104-110.
24. Rocci A, Martignoni M, Gottlow J. Immediate loading of Brånemark System with TiUnite and machined surfaces in
the posterior mandible. A randomised, open-ended trial. Clin Implant Dent Relat Res 2003;12 ( Suppl 1):57-63.
25. Rompen E, DaSilva D, Lundgren AK, Gottlow J, Sennerby L. Stability measurements of a double-threaded titanium
implant design with turned or oxidized surfaces. An experimental resonance frequency analysis study in the dog
mandible. Appl Osseointegration Res 2000;1:18-20.
26. Salata LA, Rasmusson L, Novaes AB, Papalexiou V, Sennerby L. The influence of anodic oxidation on implant
integration and stability in bone defects. An RFA study in the dog mandible. Appl Osseointegration Res 2002;3:3234.
27. Vanden Bogaerde L, Pedretti G, Dellacasa P, Mozzati M, Rangert B. Early function of splinted implants in the
maxillae and posterior mandibles using Brånemark System TiUnite implants: An 18-month prospective clinical
multicenter study. Clin Implant Dent Relat Res 2003;5 ( Suppl 1):21-28.
28. Vanden Bogaerde L, Rangert B, Wendelhag I. Immediate/early function of Brånemark System TiUnite implants in
fresh extraction sockets in the maxillae and posterior mandibles: an 18-month prospective clinical study. Clin
Implant Relat Res 2005;7 ( Suppl 1):121-131.
29. van Steenberghe D, Glauser R, Blombäck U, Andersson M, Schutyser F, Pettersson A, Wendelhag I. A computed
tomographic scan-derived customized surgical template and fixed prosthesis for flapless surgery and immediate
loading of implants in fully edentulous maxillae: a prospective multicenter study. Clin Implant Dent Relat Res
2005;7 ( Suppl 1):111-120.
30. Villa R, Rangert B. Early loading of interforaminal implants immediately installed after extraction of teeth
presenting endodontic and periodontal lesions. Clin Implant Relat Res 2005;7 ( Suppl 1):28-35.
31. Östman PO, Hellman M, Sennerby L. Direct implant loading in the edentulous maxilla using a bone densityadapted surgical protocol and primary implant stability criteria for inclusion. Clin Implant Dent Relat Res 2005;7 (
Suppl 1):60-69.
GEN 62713
April 2007
32. Aalam A-A, Nowzari H. Clinical evaluation of dental implants with surfaces roughened by anodic oxidation, dual
acid-etched implants, and machined implants. Int J Oral Maxillofac Implants 2005;20:793-798.
33. Achilli A, Tura F, Euwe E. Immediate/early function with tapered implants supporting maxillary and mandibular
posterior fixed partial dentures: Preliminary results of a prospective multicenter study. J Prosthet Dent.
2007;97(suppl):S52-S58.
34. Alsaadi G, Quirynen M, van Steenberghe D. The importance of implant surface characteristics in the replacement of
failed implants. Int J Oral Maxillofac Implants 2006;21:270-274.
35. Attard N J, David LA, Zarb GA. Immediate loading of TiUnite implants with mandibular overdentures: One-year
clinical results of a prospective study. Int J Prosthodont 2005;18:463-470.
36. Awillo K, Majewski P, Dijakiewicz M. Immediate loading of one-piece implants - Preliminary studies. EAO 2004.
Clin Oral Impl Res 2004;15 (4): lii: abstract 182.
37. Balshi SF, Wolfinger GJ, Balshi TJ. Analysis of 164 titanium oxide-surface implants in completely edentulous arches
for fixed prosthesis anchorage using the ptergomaxillary region. Int J Oral Maxollofac Implants 2005;20:946-952.
38. Becker W, Goldstein M, Becker BE, Sennerby L. Minimally invasive flapless implant surgery: a prospective
multicenter study. Clin Implant Dent Relat Res 2005; 7 (Suppl 1): 21-27.
39. Bedrossian E, Rangert B, Stumpel L, Indresano T. Immediate function with the zygomatic implant: a graftless
solution for the patient with mild to advanced atrophy of the maxilla. Int J Oral Maxillofac Implants. 2006 NovDec;21(6):937-42.
40. Brochu J-F, Anderson JD, Zarb GA. The influence of early loading on bony crest height and stability: A pilot study.
Int J Prosthodont 2005;18:506-512.
41. Buch RSR, Biner J, Wegener J, Wagner W, Reichert T. Drei Jahre klinische Erfarung mit der TiUnite-Oberfläche. Z
Zahnärztl Impl 2005;21(4) 224-228.
42. Chaussé L. Immediate loading of mandibular short implants: 24 cases at 42 months. EAO 2004. Clin Oral Impl Res
2004;15(4):lii:abstract 115.
43. Degidi M, Perrotti V, Piattelli A. Immediately loaded titanium implants with a porous anodized surface with at
least 36 months of follow-up. Clin Implant Dent Relat Res 2006;8:169-177.
44. Duyck J, Vrielink L, Lambrichts I, Abe Y, Schepers S, Politis C, Naert I. Bone response around immediately versus
delayed loaded oral implants with ill-fitting prostheses. EAO 2004. Clin Oral Impl Res 2004;15(4):lii:abstract 108.
45. Finne K, Rompen E, Toljanic J. Clinical evaluation of a prospective multicenter study on 1-piece implants. Part 1:
marginal bone level evaluation after 1 year of follow-up. Int J Oral Maxillofac implants 2007;22(2):226-34.
46. Finne K, Rompen E, Toljanic J. Prospective multicenter study of marginal bone level and soft tissue health of a onepiece implant after two years. J Prosthet Dent. 2007;97(suppl):S79-S85.
47. Friberg B, Dahlin C, Widmark G, Östman PO, Billström C. One-year results of a prospecitve multicenter study on
Brånemark System implants with a TiUnite surface. Clin Implant Dent Relat Res 2005; 7 (Suppl 1): 70-75.
48. Froberg KK, Lindh C, Ericsson I. Immediate Loading of Branemark System Implants: A Comparison Between
TiUnite and Turned Implants Placed in the Anterior Mandible. Clin Implant Dent Relat Res 2006;8:187-197.
49. Glauser R, Schüpbach, Lundgren AK, Gottlow J, Hämmerle CHF. Machined and oxidized microimplants retrieved
from humans: a comparison using histomorphometry and micro-computed tomography. EAO 2002. Abstract 64.
Clinical Oral Implants Research 2002;13:xxv.
50. Glauser R, Schüpbach P, Gottlow J, Hämmerle CHF. Periimplant soft tissue barrier at experimental one-piece miniimplants with different surface topography in humans: a light-microscopic overview and histometric analysis. Clin
Implant Dent Relat Res 2005; 7 (Suppl 1): 44-51.
51. Gottlow J, Henry P, Tan A, Allan B, Johansson C, Hall J. Biomechanical and histologic evaluation of the TiUnite
and Osseotite implant surfaces in dogs. Appl Osseointegration Res 2000;1:28-30.
52. Gottlow J, Johansson C, Albrektsson T, Lundgren AK. Biomechanical and histologic evaluation of the TiUnite and
Osseotite implant surfaces in rabbits after 6 weeks of healing. Appl Osseointegration Res 2000;1:25-27.
53. Hahn J. Clinical and radiographic evaluation of one-piece implants used for immediate function. Accepted for
publication in Journal of Oral Implantology (vol 33 issue mid-June).
54. Hahn J. Clinical evaluation of one-piece implants used for immediate function. European J Dent Implantol 2006;2:1
suppl
GEN 62713
April 2007
55. Hall J, Miranda-Burgos P, Sennerby L. Stimulation of directed bone growth at oxidized implants by macroscopic
grooves: an in vivo study. Clin Implant Dent Relat Res 2005; 7 (Suppl 1): 76-82.
56. Jungner M, Lundqvist P, Lundgren S. Oxidized titanium implants (Nobel Biocare TiUnite) compared with turned
titanium implants (Nobel Biocare mark III) with respect to implant failure in a group of consecutive patients treated
with early functional loading and two-stage protocol. Clin Oral Implants Res 2005;16:308-312.
57. Kan JYK, Rungcharassaeng K, Liddelow G, Henry P, Goodacre CJ. Periimplant tissue response following immediate
provisional restoration of scalloped implants in the esthetic zone: A one-year pilot prospective multi-center study. J
Prosthet Dent. 2007;97(suppl):S109-S118.
58. Knobloch L, Larsen PA, Rashid B, Carr AB Six-month performance of implants with oxidized and machined
surfaces restored at 2, 4, and 6 weeks postimplantation in adult beagle dogs. Int J Oral Maxillofac Implants
2004;19:350-356.
59. Kyungsoo H, Sungam C, SangHwan K. Comparison of removal torques between anodizing implant and laser treated
implant inserted in the rabbit femoral metaphysis. AO 2004 Poster #112.
60. Liddelow G, Henry PJ. A prospective study of immediately loaded single implant-retained mandibular overdentures:
Preliminary one-year results. J Prosthet Dent. 2007;97(suppl):S126-S137.
61. Malo P, de Araujo Nobre M, Petersson U, Wigren S. A pilot study of complete edentulous rehabilitation with
immediate function using a new implant design: case series. Clin Implant Dent Relat Res. 2006;8(4):223-32.
62. Malo P, de Araujo Nobre M, Rangert B. Implants placed in immediate function in peridontally compromised sites:
A five-year retrospective and a one-year prospective study. J Prosthet Dent. 2007;97(suppl):S86-S95.
63. Molly L, Quirynen M, van Steenberghe D. Influence of implant geometry and surface characteristics on primary
stability and osseointegration. EAO 2004. Clin Oral Impl Res 2004;15(4):lii:abstract 89.
64. Östman PO, Hellman M, Wendelhag I, Sennerby L. Resonance frequency analysis measurements of implants at
placement surgery. Int J Prosthodont 2006;19:77-83.
65. Palma VC, Magro-Filho O, de Oliveria JA, Lundgren S, Salata LA, Sennerby L. Bone reformation and implant
integration following maxillary sinus membrane elevation: an experimental study in primates. Clin Implant Dent
Relat Res. 2006;8(1):11-24.
66. Portmann M, Glauser R. Report of a case receiving full-arch rehabilitation in both jaws using immediate implant
loading protocols: a 1-year resonance frequency analysis follow-up. Clin Implant Dent Relat Res 2006;8:25-31.
67. Rao W, Benzi R. Single mandibular first molar implants with flapless guided surgery and immediate function:
Preliminary clinical and radiographic study. J Prosthet Dent 2007;97(suppl):S3-S14.
68. Rocci A, Gottlow J. Esthetic outcome of immediately loaded scalloped implants placed in extraction sites using
flapless surgery. A 6 month report of 4 cases. Appl Osseointegration Res 2004;4:55-62.
69. Schincaglia GP, Marzola R, Scapoli C, Scotti R. Immediate Loading of Dental Implants Supporting Fixed Partial
Dentures in the Posterior Mandible: A Randomized Controlled Split-Mouth Study: Machined Versus Titanium
Oxide Implant Surface. Int J Oral Maxillofac implants 2007;22:35-46.
70. Schüpbach P, Glauser R, Guggenheim B. Evaluation of in situ biofilms on machined, acid-etched and oxidized
titanium surfaces. EAO 2004. Clin Oral Impl Res 2004;15(4):li:abstract 82.
71. Schüpbach P, Glauser R, Lundgren AK, Gottlow J, Hämmerle CHF. Evaluation of the bone tissue around implants
by a new microtomographic technique. IADR Abstract. J Dent Res 2002;82.
72. Sennerby L, Miyamoto I. Insertion torque and RFA analysis of TiUnite and SLA implants. A study in rabbit. Appl
Osseointegration Res 2000;1:31-33.
73. Siepenkothen T, Clauder A, Mehlau R. Multiple center clinical and radiographic evaluation of one-piece implants.
European J Dent Implantol 2006;2:1 suppl
74. Siepenkothen T. Clinical performance and radiographic evaluation of a novel single-piece implant in a private
practice over a mean of seventeen months. J Prosthet Dent. 2007;97(suppl):S69-S78.
75. Stephan G, Vidot F, Noharet R, Mariani P. Implant-retained mandibular overdentures: A comparative pilot study of
immediate loading versus delayed loading after two years. J Prosthet Dent. 2007;97(suppl):S138-S145.
76. Suketa N, Sawase T, Tanaka Y, Kjellin P, Wennerberg A, Albrektsson T, Atsuta M. Photocatalytic reaction on
TiUnite surfaces. EAO 2004. Clin Oral Impl Res 2004;15(4):lii:abstract 127.
77. Turkyilmaz, I. A 3-year prospective clinical and radiologic analysis of early loaded maxillary dental implants
supporting single-tooth crowns. Int J Prosthodont, 2006; 19(4): 389-90.
GEN 62713
April 2007
78. Turkyilmaz I, Sennerby L, Tumer C, Yenigul M, Avci M. Stability and marginal bone level measurements of
unsplinted implants used for mandibular overdentures: a 1-year randomized prospective clinical study comparing
early and conventional loading protocols. Clin Oral Implants Res 2006;17:501-505.
79. Tomatis M, Calandriello R, Rangert B. Immediate loading of Brånemark implants with two different surfaces. EAO
2002. Abstract 78. Clinical Oral Implants Research 2002;13(4):abstract 78.
80. Villa R, Rangert B. Immediate and early function of implants placed in extraction sockets of maxillary infected teeth:
A pilot study. J Prosthet Dent. 2007;97(suppl):S96-S108.
81. Wöhrle P.S, Jovanovic SA A biological approach to predictable natural implant esthetics. Appl Osseointegration Res
2004;4:49-54.
82. Xiropaidis AV, Qahash M, Lim WH, Shanaman RH, Rohrer MD, Wikesjo UM et al. Bone-implant contact at
calcium phosphate-coated and porous titanium oxide (TiUnite)-modified oral implants. Clin Oral Implants Res
2005;16:532-539.
83. Yildirim M. Die Bedeutung der Oberflächentopographie in der zahnärztlichen Implantologie.
Implantol 2001;56:D30
Z Zahnärztl
84. Zechner W, Tangl S, Tepper G, Furst G, Bernhart T, Haas R, Mailath G, Watzek G. Influence of platelet-rich
plasma on osseous healing of dental implants: A histologic and histomorphometric study in minipigs. Int J Oral
Maxillofac implants 2003;18:15-22.
GEN 62713
April 2007