More than half a century ago, Professor Per-Ingvar Brånemark changed the history of world dentistry with his concept. Osseointegration. Since then, the gold standard of a successful implant has always revolved around the ability of the titanium post to firmly bond with the jawbone (Adell et al., 1981).
However, with the development of modern clinical dentistry, dentists and specialists have identified a new challenge: Long-term stability of soft tissue. Peri-implantitis and gum recession remain persistent problems, threatening the aesthetics and longevity of dental restorations even after many years of use.
Understanding that concern, Nobel Biocare officially introduces its duo of surface treatments. Xeal™ and TiUltra™. This is not just an improvement, but a testament to a new era of treatment: The Mucointegration™ Era – where integration occurs at every level, from the depths of the bone to the mucosal surface.
Why are the world's leading doctors switching to Xeal & TiUltra? The answer lies in surface chemistry technology and optimized clinical processes.
I. Xeal™: Surface Determining Height of Keratinized Tissue (Mucointegration™)
For a long time, the surface of abutments was designed to be smooth with the aim of reducing bacterial adhesion. However, recent studies have shown that smooth surfaces also limit the adhesion of soft tissue cells, creating conditions for bacteria to penetrate into the bone crest.
Xeal This is a pioneering surface applied by Nobel Biocare to its abutment lines (such as On1 Base, Multi-unit Abutment) with two groundbreaking characteristics:
Nanostructure & Surface Chemistry: Xeal is electrochemically treated to create a smooth surface with a nanostructure and a special chemical affinity for soft tissue cells. Research by Hall et al. (2019) demonstrated that this surface promotes faster and higher-density adhesion of soft tissue cells, forming a robust biological barrier protecting the underlying bone (Hall et al., 2019).
Golden Hue: Xeal's yellow color is created from the thickness of the oxide layer during the anodizing process. This helps to eliminate the metallic gray under the thin gum line, providing a natural aesthetic while ensuring absolute bioinertness.
Protective Layer: A little-known fact is that each Xeal surface abutment is protected by a specialized protective layer included in the packaging. This ensures that the chemical condition of the surface is preserved. “"Ultra-clean" And it arrives intact from the factory to the doctor's hands when the package is opened.
Clinical value: It creates a strong mucosal barrier (soft tissue seal), preventing epithelial invasion and bacterial penetration, thereby preserving stable crest height over time (Roffel et al., 2020).
II. TiUltra™: Early Bone Integration and Long-Term Stabilization (Osseointegration™)
TiUltra is an upgrade in surface finish. TiUnite Nobel Biocare's renowned line, designed to suit all clinical indications, including Soft bone, subjected to high occlusal loads, or immediate implantation..
According to research by Milleret et al. (2019), TiUltra changes the surface properties from the implant neck to the implant apex to match the biology of each cellular region:
Neck area: The surface is smooth, with a nano-structure and a pale yellow color. This characteristic facilitates natural soft tissue transitions and minimizes the risk of mucosal inflammation.
Body and apex region: The roughness increases progressively and is superhydrophilic. This activates plasma proteins upon contact, accelerating bone formation and ensuring high initial stability (Susin et al., 2019).
III. Good News for Doctors: "No Changes to Clinical Procedures"“
One of the biggest barriers to adopting new technology is having to change established practices or reinvest in surgical kits. With Xeal & TiUltra, Nobel Biocare has completely resolved this concern.
Based on official technical information:
- The drilling process remains unchanged: The doctor still uses Nobel Biocare's standard drill set and bone drilling procedure. No retraining is required.
- Digital Integration: The implant lines (NobelActive, NobelParallel CC) and abutments (On1 Base, Multi-unit) with Xeal/TiUltra surfaces are now fully updated in the DTX Studio™ software library and other CAD/CAM software.
- Backward compatibility: The prosthetic accessories retain their connections, making it easier for the dentist to manage the materials.
IV. Strong Scientific Evidence
Nobel Biocare's confidence is built on a foundation of evidence-based medicine. All the foundational research on Xeal and TiUltra has been published in special supplements of prestigious journals. Clinical Implant Dentistry and Related Research (CIDRR) in March 2019.
This demonstrates that Xeal & TiUltra is not an "experiment," but the result of a long and rigorous scientific research process.
Conclusion & Order Now
In Vietnam, Ndent We are proud to offer our esteemed doctors the complete Xeal & TiUltra solution across our flagship implant lines:
- NobelActive® TiUltra™
- NobelParallel™ CC TiUltra™
- On1™ Base Xeal™
- Xeal™ Multi-unit Abutment
Don't let your doctor's clinic be left out of the "Mucointegration Era." Contact Ndent today to be among the first to own the most advanced surface technology.
References
Adell, R., Lekholm, U., Rockler, B., & Brånemark, P.I. (1981). A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. International Journal of Oral Surgery, 10(6), 387–416.
Hall, J., Roffel, S., & Friberg, B. (2019). A novel bio‐functionalization of implant abutment surfaces to enhance mucosal integration: A canine study. Clinical Implant Dentistry and Related Research, 21(S1), 12–19. https://doi.org/10.1111/cid.12746
Milleret, V., Lienemann, P.S., Gasser, A., Bauer, S., Ehrbar, M., & Wennerberg, A. (2019). Tuning the surface properties of dental implants to create a gradual tissue-implant interface. Clinical Implant Dentistry and Related Research, 21(S1), 6–11. https://doi.org/10.1111/cid.12738
Roffel, S., Wu, G., & Wismeijer, D. (2020). Soft tissue attachment on a novel anodized titanium surface: A split-mouth randomized controlled clinical trial. Clinical Implant Dentistry and Related Research, 22(6), 682–690.
Susin, C., Fiorini, T., Lee, J., De Stefano, J.A., Dickinson, D.P., & Wikesjö, UME. (2019). Surface characteristics and clinical performance of a new anodized implant surface: A randomized controlled clinical trial. Clinical Implant Dentistry and Related Research, 21(S1), 20–29. https://doi.org/10.1111/cid.12750
Clinical Implant Dentistry and Related Research. (2019). A New Era in Mucointegration and Osseointegration Driven by Surface Chemistry [Special issue]. Clinical Implant Dentistry and Related Research, 21(S1).
