Bulletin of Stomatology and Maxillofacial Surgery
ISSN 1829-006X
2025; 435–451
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NANOSTRUCTURED COATING MATERIALS ON TITANIUM IMPLANTS FOR ENHANCED OSSEOINTEGRATION AND CLINICAL OUTCOMES A SYSTEMATIC REVIEW AND META-ANALYSIS

Vishnuvaradhan Venkatachalam*, Jayalakshmi Somasundaram, Deepak E R

Saveetha Institute of Medical and Technical Science (SIMATS), Saveetha University, Chennai -600077, Tamil Nadu, India. · Saveetha Dental College Saveetha Institute of Medical and Technical Sciences (SIMATS) Chennai – 600077, India · JKKN Dental college, Kumarapalayam, Namakkal, Tamil Nadu, India.

Received: 2026-04-08 · Published: 2025-11-20

© 2025 The Author(s) and the original publisher.

CC BY-NC 4.0 This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
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Originally published in Bulletin of Stomatology and Maxillofacial Surgery, 2025 — https://doi.org/10.58240/1829006X-2025.21.10-435.

Original title
NANOSTRUCTURED COATING MATERIALS ON TITANIUM IMPLANTS FOR ENHANCED OSSEOINTEGRATION AND CLINICAL OUTCOMES A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors
Vishnuvaradhan Venkatachalam, Jayalakshmi Somasundaram, Deepak E R
Source journal
Bulletin of Stomatology and Maxillofacial Surgery
Published
2025-11-20
Licence
Creative Commons Attribution-NonCommercial 4.0 International
Original
https://doi.org/10.58240/1829006X-2025.21.10-435

Abstract

Statement of Problem:Titanium implants, while widely used in dental and orthopedic applications, often face challenges related to early-stage osseointegration and implant failure, particularly in compromised patients. Surface modifications using nanostructured coatings have been proposed to improve implant integration and biological performance, yet evidence across studies remains fragmented. Purpose:To systematically evaluate and quantify the impact of nanostructured coatings on titanium implants in terms of osseointegration, mechanical fixation, and clinical performance through a comprehensive review and meta-analysis. Materials and Methods:This systematic review and meta-analysis followed PRISMA guidelines. A thorough literature search was conducted across PubMed, Scopus, Web of Science, and other databases to identify eligible in vivo, in vitro, and clinical studies evaluating nanostructured coatings on titanium implants. A total of 51 studies were included. Key outcomes such as bone-to-implant contact (BIC), removal torque values, and histological bone formation were extracted. Risk of bias was assessed using SYRCLE and modified ToxRTool. Meta-analyses were conducted using a random-effects model, and heterogeneity was evaluated using I² statistics. Funnel plots and Egger’s regression were used to assess publication bias. Results:Nanostructured coatings significantly improved osseointegration indicators. Meta-analysis revealed substantial improvements in removal torque (Cohen’s d = 5.97; 95% CI: 3.72–8.22), bone-to-implant contact (Cohen’s d = 4.68; 95% CI: 2.95–6.41), and histomorphometric outcomes. Heterogeneity was moderate to high (I² ≈ 60–65%). Subgroup analyses highlighted variation in effectiveness based on coating materials (e.g., TiO₂ nanotubes, hydroxyapatite, metal ions). Funnel plots and Egger’s test indicated minimal publication bias. Conclusions:Nanostructured coatings on titanium implants significantly enhance early-stage osseointegration and biomechanical stability, with additional potential for antibacterial properties. While preclinical evidence is robust, further multicentric clinical trials with standardized protocols are required to confirm translational efficacy and longterm outcomes.
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