Non-Cochrane · intervention · PM42802882
Long-Term Peri-Implant Outcomes of Smoother/Hybrid Versus Moderately Rough Titanium Implant Surfaces: An Updated Systematic Review and Meta-Analysis.
Delgado Castromonte Heliette Emperatriz E, Jaramillo Arturo P, Hernandez Jiménez Juan S, et al. · Cureus · 2026 · PubMed · doi:10.7759/cureus.115357
Findings
Population Adults receiving root-form titanium dental implants
4 findings
| Smoother, minimally rough, machined or hybrid titanium implant surfaces | Moderately rough or rougher titanium implant surfaces | Implant failure At least 24 months; longest eligible follow-up | RR 2.12 [0.85, 5.31] Very low Downgraded: risk of bias, imprecision 7 studies |
| Smoother, minimally rough, machined or hybrid titanium implant surfaces | Moderately rough or rougher titanium implant surfaces | Marginal bone-level change At least 24 months; longest eligible follow-up Unresolved: the two extractors disagree on this row. | MD 0.07 [-0.12, 0.27] Very low Downgraded: risk of bias, imprecision, inconsistency 8 studies |
| Smoother, minimally rough, machined or hybrid titanium implant surfaces | Moderately rough or rougher titanium implant surfaces | Peri-implant probing depth At least 24 months; longest eligible follow-up | MD -0.36 [-0.93, 0.21] Very low Downgraded: risk of bias, imprecision, inconsistency 4 studies |
| Smoother, minimally rough, machined or hybrid titanium implant surfaces | Moderately rough or rougher titanium implant surfaces | Marginal bone-level change At least 24 months; longest eligible follow-up · Sensitivity analysis excluding high risk of bias reports | MD -0.06 [-0.29, 0.16] GRADE not reported 5 studies |
Included primary studies 10
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Donati 2018 Marginal bone loss at implants with different surface characteristics - A 20-year follow-up of a randomized controlled clinical trial. PMID:29569767 | 2018 | this review only | Marginal bone-level change; Peri-implant probing depth | not extracted yet |
| Glibert 2024 matched by author and year (probable) | NR | this review only | Marginal bone-level change; Peri-implant probing depth; Implant failure | not extracted yet |
| Nicu 2012 RCT comparing implants with turned and anodically oxidized surfaces: a pilot study, a 3-year follow-up. PMID:23151294 | 2012 | this review only | Peri-implant probing depth | not extracted yet |
| Offord 2025 Four-Year Outcomes of Immediately Loaded Full-ArchMaxillary Dental Implants with Hybrid Versus Roughened Surfaces: A Split-Mouth… PMID:41303033 | 2025 | this review only | Marginal bone-level change; Implant failure | not extracted yet |
| Raes 2018 A 5-year randomized clinical trial comparing minimally with moderately rough implants in patients with severe periodontitis. PMID:29611221 | 2018 | this review only | Marginal bone-level change; Peri-implant probing depth; Implant failure | not extracted yet |
| Rocci 2013 Immediate loading of Brånemark system TiUnite and machined-surface implants in the posterior mandible, part II: a randomized open-ended… PMID:23748324 | 2013 | this review only | Marginal bone-level change; Implant failure | not extracted yet |
| Rothamel 2022 Impact of machined versus structured implant shoulder designs on crestal bone level changes: a randomized, controlled, multicenter study. PMID:35841488 | 2022 | this review only | Marginal bone-level change; Implant failure | not extracted yet |
| Serrano 2025 Three-Year Outcomes of Dental Implants With a Hybrid Surface Macro-Design Placed in Patients With History of Periodontitis: A Randomised… PMID:40277088 | 2025 | this review only | Marginal bone-level change; Implant failure | not extracted yet |
| Tirone 2021 Three-Year Evaluation of the Influence of Implant Surfaces on Implant Failure and Peri-implantitis: A Double-Blind Randomized Controlled… PMID:33909728 | 2021 | this review only | Marginal bone-level change; Implant failure | not extracted yet |
| Zetterqvist 2010 A prospective, multicenter, randomized-controlled 5-year study of hybrid and fully etched implants for the incidence of peri-implantitis. PMID:20367092 | 2010 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adults receiving root-form (endosseous) titanium dental implants | Adults with titanium implants, from periodontally healthy fully edentulous patients to treated severe periodontitis; single crowns, partial fixed restorations, mandibular overdentures, immediately loaded maxillary full arch (n=10 reports; 480 participants; 1,219 implants) |
| Intervention | Machined, turned, minimally rough, or hybrid implants with a smoother coronal component | Turned/machined/minimally rough surfaces or hybrid machined/minimally rough coronal zone (n=10) |
| Comparison | Moderately rough or rougher implants | Moderately rough surfaces (TiOblast, anodically oxidized TiUnite, continuously etched, structured shoulder, fully moderately rough) (n=10) |
| Outcomes | Primary: marginal bone-level change; secondary: peri-implant probing depth, implant failure; peri-implant disease (in PICOS question) | Marginal bone-level change (n=8; 671 analysis units); peri-implant probing depth (n=4; 268 analysis units); implant failure (n=7; 773 implants); peri-implant outcomes narrative only (n=1) |
| Study designs | Randomized clinical trials | Randomized clinical trials: parallel, multicenter and split-mouth (n=10) |
| Timing | At least 24 months of follow-up after implant placement or loading; longest eligible time point | 24 months to 20 years |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | No | No | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | No | Partial Yes | no |
| 5Study selection in duplicate | No | No | yes |
| 6Data extraction in duplicate | No | No | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Yes | no |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | RCT: Yes · NRSI: N/A | yes |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: No · NRSI: N/A | RCT: Yes · NRSI: N/A | no |
| 12Impact of risk of bias on the pooled results | Yes | Yes | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |