Metallic biomaterials have been extensively used in orthodontics throughout history. Gold, stainless steel, cobalt-chromium alloys, titanium and its alloys, among other metallic biomaterials, have been part of the orthodontic armamentarium since the twentieth century. Metals and alloys possess outstanding properties and offer numerous possibilities for the fabrication of orthodontic devices such as brackets, wires, bands, ligatures, among others. However, these materials have drawbacks that can present problems for the orthodontist. Poor friction control, allergic reactions, and metal ionic release are some of the most common disadvantages found when using metallic alloys for manufacturing orthodontic appliances. In order to overcome such weaknesses, research has been conducted aiming at different approaches, such as coatings and surface treatments, which have been developed to render these materials more suitable for orthodontic applications. The purpose of this paper is to provide an overview of the coating and surface treatment methods performed on metallic biomaterials used in orthodontics.

Dental ceramic implants have shown superior esthetic behavior and the absence of induced allergic disorders when compared to titanium implants. Zirconia may become a potential candidate to be used as an alternative to titanium dental implants if surface modifications are introduced. In this work, bioactive micropatterned silica coatings were produced on zirconia substrates, using a combined methodology of sol-gel processing and soft lithography. The aim of the work was to compare the in vitro behavior of human gingival fibroblasts (HGFs) and human dermal microvascular endothelial cells (HDMECs) on three types of silica-coated zirconia surfaces: flat and micropatterned (with pillars and with parallel grooves). Our results showed that cells had a higher metabolic activity (HGF, HDMEC) and increased gene expression levels of fibroblast-specific protein-1 (FSP-1) and collagen type I (COL I) on surfaces with pillars. Nevertheless, parallel grooved surfaces were able to guide cell growth. Even capillary tube-like networks of HDMEC were oriented according to the surface geometry. Zirconia and silica with different topographies have shown to be blood compatible and silica coating reduced bacteria adhesion. All together, the results indicated that microstructured bioactive coating seems to be an efficient strategy to improve soft tissue integration on zirconia implants, protecting implants from peri-implant inflammation and improving long-term implant stabilization. This new approach of micropatterned silica coating on zirconia substrates can generate promising novel dental implants, with surfaces that provide physical cues to guide cells and enhance their behavior.