Histologic and Immunohistochemical Analysis of Peri-implant Tissue Regeneration at the Interface of Prosthetic Abutments Treated with Anodizing: A Prospective, Randomized Controlled Clinical Trial on the Early Postoperative Period
Clinical Snapshot
PICO Framework
| P — Population | Adults receiving dental implants with osseointegration requiring prosthetic abutments |
| I — Intervention | Anodized surface treatment on custom healing abutments |
| C — Comparator | Machined surface custom healing abutments |
| O — Outcomes | Histologic parameters including inflammatory response, vascular proliferation, epithelial stratification, collagen organization, and immunohistochemical markers (CD34, β-catenin) |
Bottom Line
This small RCT suggests anodized prosthetic abutments may promote better peri-implant tissue healing compared to machined surfaces, showing reduced inflammation and improved vascular markers at 30 days post-placement. However, the study has significant methodological limitations including unclear randomization, lack of blinding, missing confidence intervals, and absence of patient-centered outcomes. The clinical significance of these histologic changes remains uncertain without longer follow-up or correlation with clinical parameters like probing depths or patient symptoms. While the biological rationale is sound and results promising, stronger evidence from larger, better-designed trials with clinical endpoints is needed before changing practice. Australian clinicians should await more robust evidence before routinely recommending anodized abutments, though the intervention appears safe and may offer modest benefits in selected cases.
Key Findings
P Value: P < 0.05 for inflammatory response and CD34 expression
Effect Size: Significantly reduced inflammatory infiltrate and increased CD34 immunopositivity in anodized group
Primary Outcome: Inflammatory response intensity significantly lower in anodized group (G2) compared to machined group (G1)
Nnt Or Sensitivity: Not calculable from available data
Confidence Interval: Not reported
Clinical Application
Anodizing treatment readily available in Australian dental laboratories; minimal additional cost or complexity Relevant to Australian dental implant practice; compatible with TGA-approved implant systems; may influence future RACGP referral guidelines for implant dentistry Adult patients receiving dental implants requiring prosthetic abutments in specialist dental practice
Abstract
PURPOSE: To assess the effects of anodized prosthetic abutments versus machined abutments on peri-implant connective tissue. MATERIALS AND METHODS: Following dental implant placement and osseointegration, custom healing abutments with machined surfaces (G1) and anodized surface treatment (G2) were attached to 28 dental implants. After a soft tissue healing period of approximately 30 days (± 7 days), 5-mm circular biopsy samples were taken from the peri-implant tissue and the area adjacent to the prosthetic abutment. Histologic analysis was conducted on the stained specimens using hematoxylin-eosin (H&E), focusing on parameters such as vascular proliferation as well as the presence of polymorphonuclear and mononuclear cells, collagen fibrils, and reepithelialization. A grading scale from 0 to 3 evaluated the extent of the inflammatory response. Masson's trichrome staining was used to analyze collagen fiber presence and organization, while immunohistochemical staining assessed the expression of beta-catenin (β-catenin) and Cluster of Differentiation 34 (CD34). The prosthetic abutments were evaluated through scanning electron microscopy and 3D roughness analysis. RESULTS: Histologic findings revealed that peri-implant tissue adjacent to anodized surfaces exhibited epithelial stratification and a parakeratin layer in the lamina propria. Both groups displayed a typical mononuclear lymphocytic inflammatory infiltrate, but the intensity was significantly higher adjacent to the machined abutment (P < .05). Quantification of blood vessels indicated increased immunopositivity for CD34 in G2 compared to G1 (P < .05). Immunolabeling of β-catenin was detected in the epithelial tissue, showing weak intensity in G1 and strong intensity in G2. The average surface roughness measurements were determined to be 0.097 ± 0.006 μm for G1 and 0.182 ± 0.008 μm for G2. CONCLUSIONS: Anodized surfaces are a promising treatment option and exhibit beneficial effects on peri-implant tissue healing. They play an important role in preserving the epithelial mucosal integrity and functionality near the prosthetic abutment, thereby potentially minimizing the risks of mucositis, peri-implantitis, and implant failure.
References
- 1.de Souza, V. Z., Manfro, R., Teixeira, L. N., Elias, C. N., Joly, J. C., & Martinez, E. F. (2026). Histologic and immunohistochemical analysis of peri-implant tissue regeneration at the interface of prosthetic abutments treated with anodizing: A prospective, randomized controlled clinical trial on the early postoperative period. The International Journal of Oral & Maxillofacial Implants. https://doi.org/10.11607/jomi.11301
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