1874-2106/21 Send Orders for Reprints to reprints@benthamscience.net 137 DOI: 10.2174/1874210602115010137, 2021, 15, 137-144 The Open Dentistry Journal Content list available at: https://opendentistryjournal.com SYSTEMATIC REVIEW Osseointegration of Hafnium when Compared to Titanium - A Structured Review Vaishnavi Rajaraman 1,* , Deepak Nallaswamy 2 , Dhanraj M. Ganapathy 3 and Saloni Kachhara 3 1 Department of Prosthodontics, Saveetha University, Chennai- 600077, India 2 Saveetha Dental College and Hospital, Saveetha Institute Of Medical and Technical Sciences, Saveetha University, Chennai, India 3 Department of Prosthodontics and Implantology, Saveetha Dental College and Hospital, Saveetha Institute Of Medical and Technical Sciences, Saveetha University, Chennai, India Abstract: Aim: This systematic review was conducted to analyse osseointegration of hafnium over conventional titanium. Materials and Methods: Search methodology was comprehended using PICO analysis and a comprehensive search was initiated in PubMed Central, Medline, Cochrane, Ovid, Science Direct, Copernicus and Google Scholar databases to identify the related literature. Randomised control trials, clinical studies, case control studies and animal studies were searched for osseointegration of hafnium coated titanium implants versus conventional titanium implants. Timeline was set to include all the manuscripts published till December 2018 in this review. Clinical Significance: Hafnium is a very promising surface coating intervention that can augment osseointegration in titanium implants. If research could be widened, including in vivo studies on hafnium as a metal for coating over dental implants or as a dental implant material itself to enhance better osseointegration, it could explore possibilities of this metal in the rehabilitation of both intra and extra oral defects and in medically compromised patients with poor quality of bone. Results: Out of the 25 articles obtained from the PICO based keyword search, 5 studies were excluded based on title and abstract. Out of the remaining 20 studies, 16 were excluded based on the inclusion and exclusion criteria of our interest and finally, 4 were included on the basis of core data. Conclusion: This systematic review observed hafnium metal exhibited superior osseointegration than titanium. Owing to its biocompatibility, hafnium could be an alternative to titanium, in the near future. Keywords: Osseointegration, Hafnium, Conventional titanium, Bone implant contact, Titanium alloys, Tantalum. Article History Received: July 14, 2020 Revised: November 24, 2020 Accepted: November 25, 2020 1. INTRODUCTION The advent of tissue engineering provides a novel approach for the repair and reconstruction of bone defects [ 1 - 4]. An ideal implant material should have appropriate biocompa- tibility, corrosion resistance, elastic modulus, and favourable * Address correspondence to this author at Department of Prosthodontics, Saveetha Dental College and Hospital, Saveetha Institute Of Medical and Technical Sciences, Saveetha University, Chennai, India; Tel: +8779565950; E-mail: drvaish.sav@gmail.com bone anchorage [ 5 - 12]. One of the most commonly used materials is titanium for its low elastic modulus, good corro- sion resistance and biocompatibility. Hence it has become the most commonly used biomaterial for dental implants [13 - 15]. In various studies conducted to date, Tantalum has revealed superior properties fulfilling the criteria required for an implant [ 16 - 20]. Tantalum has been shown to be a promising material for excellent chemical stability, fluid body resistance, biological inertness and remarkable osteocon-