Optimization of blood and protein flow around superhydrophilic implant surfaces by promoting contact hemodynamics

J Prosthodont Res. 2023 Oct 13;67(4):568-582. doi: 10.2186/jpr.JPR_D_22_00225. Epub 2022 Dec 22.

Abstract

Purpose: We examined blood and protein dynamics potentially influenced by implant threads and hydrophilic/hydrophobic states of implant surfaces.

Methods: A computational fluid dynamics model was created for a screw-shaped implant with a water contact angle of 70° (hydrophobic surface) and 0° (superhydrophilic surface). Movements and density of blood and fibrinogen as a representative wound healing protein were visualized and quantified during constant blood inflow.

Results: Blood plasma did not occupy 40-50% of the implant interface or the inside of threads around hydrophobic implants, whereas such blood voids were nearly completely eliminated around superhydrophilic implants. Whole blood field vectors were disorganized and random within hydrophobic threads but formed vortex nodes surrounded by stable blood streams along the superhydrophilic implant surface. The averaged vector within threads was away from the implant surface for the hydrophobic implant and towards the implant surface for the superhydrophilic implant. Rapid and massive whole blood influx into the thread zone was only seen for the superhydrophilic implant, whereas a line of conflicting vectors formed at the entrance of the thread area of the hydrophobic implant to prevent blood influx. The fibrinogen density was up to 20-times greater at the superhydrophilic implant interface than the hydrophobic one. Fibrinogen density was higher at the interface than outside the threads only for the superhydrophilic implant.

Conclusions: Implant threads and surface hydrophilicity have profound effects on vector and distribution of blood and proteins. Critically, implant threads formed significant biological voids at the interface that were negated by superhydrophilicity-induced contact hemodynamics.

Keywords: Bone-implant integration; Computational fluid dynamics (CFD); Osseointegration; Titanium implant; UV activation/photofunctionalization.