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31 Mar 2019 | Australasian Dental Practice

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Welcome to the Mucointegration™ era

Surface science is taking tissue integration solutions to the next level. In fact, it takes tissue integration to every level.

Nobel Biocare introduces the Xeal abutment surface and TiUltra implant surface, derived from decades of applied anodization expertise. From abutment to implant apex, surface chemistry and topography have been reimagined to optimize tissue integration at every level. Going beyond the mastery of osseointegration alone, Nobel Biocare enters the Mucointegration™ era.

Xeal: The pioneering Mucointegration surface

Dense soft-tissue contact with an abutment can act as a barrier to protect the underlying bone and is the basis for long-term tissue health and stability.1-4 Xeal is a pioneering surface for soft-tissue integration that demonstrates a statistically significant increase in soft-tissue height compared to machined abutments.5 A smooth, non-porous, nanostructured and anodized surface, Xeal possesses surface chemistry and topography that are specially designed to promote soft-tissue attachment.6-8

TiUltra: More than roughness

When it comes to osseointegration, treatment success with implants that have a moderately rough anodized surface is well proven.9,10 Now, Nobel Biocare's extensive expertise in anodization technology has led to the creation of TiUltra, an ultra-hydrophilic, multi-zone implant surface11-17 that goes beyond roughness alone - it grasps the power of chemistry too.

TiUltra's precisely tailored surface chemistry is achieved by anodizing the surface with a specific electrolytic solution. This solution enhances the chemical composition of the oxide layer to positively influence the interaction between surface and proteins.

For ideal integration and long-term tissue stability, different tissues demand different surfaces. To meet this need, TiUltra's topography changes gradually from a minimally rough, non-porous and nanostructured collar to a moderately rough and porous apex.11-17 Fundamentally, it respects the natural transition from hard, dense cortical bone to spongy, porous cancellous bone to achieve the ultimate goal of both early osseointegration and long-term bone stability.18,19

Pristine surface from production to placement

The pristine surface chemistry and hydrophilicity of Xeal and TiUltra, achieved with Nobel Biocare's extensive expertise in implant surfaces, are preserved throughout shelf-life by a Protective Layer, which dissolves when in contact with any liquid, such as blood.16,17,20 This layer ensures that the quality of implant and abutment surface is maintained from production to placement - for the ultimate benefit of the patient.

Surface science matters

Nobel Biocare makes no compromise in maintaining an unshakeable focus on deep science behind new solutions. Building on the foundation of nearly two decades' research supporting the success of anodized-surface implants, rigorous science and testing has been a key driving force behind the creation of Xeal and TiUltra, on a fundamental mission towards long-term treatment success. While some manufacturers may be satisfied with introducing solutions with little or no evidence, it's scientific scrutiny that really counts for Nobel Biocare.

For an in-depth insight into the evidence supporting Xeal and TiUltra, a dedicated supplement to Clinical Implant Dentistry and Related Research will provide a compelling story from design and in vitro characterisation, to behaviour in animal studies and most notably, to the pre-market clinical study.

The new Xeal surface is available for the On1 Base and the Multi-unit Abutment. TiUltra is available on Nobel Biocare's best-selling NobelActive and Nobel-Parallel Conical Connection implants.


  1. Rompen E, Domken O, Degidi M, et al. The effect of material characteristics, of surface topography and of implant components and connections on soft tissue integration: a literature review. Clin Oral Implants Res 2006;17 Suppl 2:55-67.
  2. Alva H, Prasad KD, Prasad AD. Bioseal: The physiological and biological barrier for osseointegrated supported prosthesis. J Dent Implant 2013;3:148-52.
  3. Touati B, Rompen E, Van Dooren E. A new concept for optimizing soft tissue integration. Pract Proced Aesthet Dent. 2005;17(10):711-715.
  4. Schupbach P, Glauser R. The defense architecture of the human periimplant mucosa: a histological study. J Prosthet Dent. 2007 Jun;97(6 Suppl):S15-25.
  5. Data on file: GEN 164420_00.
  6. Data on file: REP 162317 Role of topography of abutment surfaces in soft tissue attachment.
  7. Data on file: REP 158355 Role of dental abutment surface hydrophilicity in soft tissue attachment.
  8. Data on file: REP 163508 Role of dental abutment surface hydrophilicity in soft tissue attachment.
  9. Wennerberg, Alrektsson T, Chracanovic B. Long-term clinical outcome of implants with different surface modification. Eur J Oral Implantol 2018;11(Suppl 1): S123–S136.
  10. Karl M and Albrektsson T. Clinical performance of dental implants with a moderately rough (TiUnite) surface: A meta-analysis of prospective clinical studies, Int J Oral Maxillofac Implants. 2017;32(4):717-734.
  11. Data on file: DRW 153988_01 NobelActive RP 4.3x13 semi.
  12. Data on file: DRW 155372 NobelActive TiUltra RP 4.3x13.
  13. Data on file: SPE 154675_01.
  14. Data on file: SPE 154676_01.
  15. Data on file: SPE 157878_01.
  16. Data on file: TER 153292 Design Verification TiUltra Implants.
  17. Manuscript: Rational design of novel dental implant and abutment surfaces for balancing clinical and biological needs.
  18. Data on file: REP 159199 TiUltra design rationale.
  19. Data on file: TIR 160604.
  20. Data on file: REP 163930_01_Stability_Functional_Testing_SKIN_Implants_Shelf_life.
  21. Data on file: TIR 161859.
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