Surface modification of Zr implants through Micro-Arc Oxidation and in-vitro evaluation of physiological reaction – A systematic review

Purpose: This systematic review evaluated the efficacy of MAO-coated oxide layers on the surface of pure Zr implant in enhancing bioactivity, cell adhesion, and corrosion resistance. Materials and Methods: Research articles were retrieved through electronic databases from January 2010 to April 2024 following population (pure Zr or Zr-based alloy samples), intervention (coating induced through the MAO process), comparison (uncoated Zr samples), and outcomes (biocompatibility, corrosion resistance, and cell adhesion) guidelines. The major evaluation metrics were biocompatibility and corrosion resistance. Results: Six hundred and fifty-four studies were found, of which eight were selected based on the inclusion criteria. All of the in-vitro studies disclosed the effectiveness of MAO-coated zirconium implants in enhancing biocompatibility, cell adhesion, anti-bacterial activity, and corrosion resistance. The selected studies incorporated different combinations of elements through the MAO technique. Most of them expressed the outcomes by biocompatibility and corrosion resistance. Conclusions: According to the selected studies, the outcomes revealed a productive influence of MAO-coated oxide layers on the bioactivity and corrosion resistance of the zirconium implant. Further in vivo research will be needed to determine the outcomes inside the living organisms. (JOURNAL OF DENTAL IMPLANT RESEARCH 2024;43(4):67-76)