Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY.
Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain.
J Prosthodont. 2022 Aug;31(7):571-578. doi: 10.1111/jopr.13446. Epub 2021 Nov 20.
To review the most up to date scientific evidence concerning the technical implications, soft tissue biocompatibility, and clinical applications derived from the use of titanium nitride hard thin film coatings on titanium alloy implant abutments.
A review was performed to answer the following focused question: "What is the clinical reliability of nitride coated titanium alloy abutments?". A MEDLINE search between 1980 and 2021 was performed for investigations pertaining to the clinical use of nitride coated titanium alloy implant abutments (TiN) in case reports, case series, and short- and long-term non/randomized controlled clinical trials. Literature analysis led to addition evaluation of research related to the technical and biological aspects, as well as the physicochemical characteristics of TiN hard thin film coatings and their impact on titanium abutment biocompatibility, mechanical properties, macroscopic surface topography, and optical properties. Therefore, preclinical data from biomechanical and in vitro investigations were also considered as inclusion criteria.
The limited number of clinical investigations published made a systematic review and meta-analysis not possible, therefore a narrative review was conducted. TiN coatings have been applied to dental materials and instruments to improve their clinical longevity. Implant abutments are coated with titanium nitride to mask the titanium oxide surface and enhance its surface characteristics providing the TiN abutment surface with a low friction coefficient and a very high chemical inertness. TiN coating is suggested to reduce early bacterial colonization and biofilm formation and enhance fibroblast cell proliferation, attachment and adhesion when compared to Ti controls. Additionally, studies indicate that hard thin film coatings enhance the mechanical properties (hardness and wear resistance) of titanium alloy and appears as a yellow color when deposited on the titanium alloy substrate. To date, clinical investigations show that nitride coated titanium abutments provide promising short-term clinical outcomes.
Published research on nitride-coated abutments is still limited, however, the available biomedical research, mechanical engineering tests, in vitro investigations, and short-term clinical trials have, to date, reported promising mechanical, biological, and esthetic outcomes.
综述关于氮化钛硬质薄膜涂层在钛合金种植体基台上应用的技术影响、软组织生物相容性和临床应用的最新科学证据。
为回答以下聚焦问题进行了综述：“氮化钛涂层钛合金基台的临床可靠性如何？”。对 1980 年至 2021 年间与氮化钛涂层钛合金种植体基台（TiN）在病例报告、病例系列和短期及长期非/随机对照临床试验中的临床应用相关的研究进行了 MEDLINE 检索。文献分析导致对 TiN 硬质薄膜涂层的技术和生物学方面以及理化特性及其对钛基台生物相容性、机械性能、宏观表面形貌和光学性能的影响的相关研究进行了补充评估。因此，也将 TiN 硬质薄膜涂层的技术和生物学方面以及理化特性及其对钛基台生物相容性、机械性能、宏观表面形貌和光学性能的影响的相关研究作为纳入标准，纳入了生物力学和体外研究的临床前数据。
发表的临床研究数量有限，因此无法进行系统评价和荟萃分析，因此进行了叙述性综述。TiN 涂层已应用于牙科材料和器械以提高其临床寿命。氮化钛涂层被应用于种植体基台，以掩盖钛氧化物表面并增强其表面特性，使 TiN 基台表面具有低摩擦系数和极高的化学惰性。与 Ti 对照相比，TiN 涂层被认为可以减少早期细菌定植和生物膜形成，并增强成纤维细胞的增殖、附着和黏附。此外，研究表明，硬质薄膜涂层可增强钛合金的机械性能（硬度和耐磨性），并且当沉积在钛合金基底上时呈现黄色。迄今为止，临床研究表明，氮化钛涂层钛合金基台提供了有前景的短期临床结果。
关于氮化钛涂层基台的研究仍然有限，但是，现有的生物医学研究、机械工程测试、体外研究和短期临床试验迄今为止报告了有前途的机械、生物学和美学结果。
