CLINICIAN > THE INNOVATIVENESS OF THE UTM FINISHING
Implantology of the future will be the modulation of the biological signals that control cell differentiation in a harmonic and biomimetic way.
This challenge starts from a distance, from painstaking research and analysis of the in-vitro and in-vivo cell responses. It is a long road where each improvement that reaches the dentist conceals a history of attempts, failures, frustrations, but also of enthusiasm, inspirations and discoveries. This road requires the contribution of everyone, including researchers, dentists and users. This journey is difficult and challenging, but at the same time, is changing the way of doing dentistry.
Prof. Guido Maria Macaluso – Università di Parma
THE IMPLANT SURFACE: AN ALTERNATIVE NICHE
Introduction of Scientifica Vol.I – January 2011
The innovativeness of the UTM surface
The UTM (Ultrathin Threaded Microsurface) surface with its roughness of 60 micron has been specifically designed to be an excellent substrate for both soft and hard tissues. It is not a machined surface, but a microthreading properly designed to enhance the cellular organization, exploiting the principle of contact guidance, according to which cells are led to arrange themselves and move following the surrounding topographic stimuli. The fibroblasts are then guided in this one-way environment, as if they are in a rail, where they can only stretch and contract. The controlled and guided movement allows the cells to position themselves correctly in the microthread, spending little of their energy, which therefore remains available for what is the ultimate destiny of each cell: duplication.
SEM images of the UTM surface
Arrangement of murine fibroblasts on UTM surface after 72 hours, observed with fluorescence microscopy - in vitro experiment. Images courtesy of the Dentistry department of the University of Parma.
Clinical observation has always suggested that the synergy between UTM surface and convergent neck could be the reason for that dense and stable tissue compartment capable of creating a very effective connective seal, as confirmed by histological analyses, which however remain a two-dimensional view of a very complex environment.
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Thanks to a revolutionary histological study in humans carried out through synchrotron tomography, published in Clinical Oral Implants Research, it was possible to observe the structure of collagen fibers in three different conformations: divergent profile with machined neck (like the majority of transmucosal implants or traditional prosthetic emergences), machined convergent profile and convergent profile with UTM surface (such as the Prama neck).
Courtesy of Dott. Giuseppe Pellitteri
Synchrotron microtomography has shown that the soft tissues in contact with the UTM surface on a convergent support develop a greater quantity of collagen fibres, organized in intertwined and more compact bundles. This three-dimensional vision explains the biological reasons for the favorable healing of the soft tissues around the Prama neck, stable over time.
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While designed to support soft tissue, the UTM surface has been shown to osseointegrate as early as 3 months, in both hard and poorly mineralized bone.
Based on the histological images shown on the side, where new bone also in contact with the UTM surface is observable, we can support the deeper insertion of the implant and its positioning in post-extraction sites in which part of the UTM neck is in contact with the bone (typically with the mesio-distal peaks and with the lingual or palatal wall) and part in contact with the soft tissues (vestibular portion).