Surface Engineering of Zirconia Implants: Current Options and Innovations

Abstract Purpose of Review To present the main physico-chemical surface conditioning methods and surface coatings described in the literature for zirconia implants. Recent Findings The reviewed literature shows that methods such as air-abrasion, acid etching, Selective Infiltration Etching (SIE), laser irradiation, ultraviolet light treatments, and various coatings such as calcium phosphates, bioactive glasses, titanium dioxide, graphene, and polydopamine help increase surface roughness and area, promote osteogenesis, and improve osseointegration of zirconia implants. Summary Despite the excellent mechanical performance and biocompatibility of zirconia implants, they cannot trigger an initial response from the surrounding tissues after implantation due to their bioinertia. Therefore, in order to achieve reliable and predictable osseointegration, surface conditioning methods and coatings should be applied to zirconia implant surfaces with the main goal of enhancing bone-implant interaction. More recently, the addition of peptides and biomolecules to these surfaces has helped in developing bioactive surfaces.