Correlation between primary stability and bone healing of surface treated titanium implants in the femoral epiphyses of rabbits

The aim of this study was to analyse the stability and osseointegration of surface treated titanium implants in rabbit femurs. The implants were either grit-blasted and acid-etched (BE Group), calcium phosphate (CaP) coated by using the electrodeposition technique, or had bioactive molecules incorporated into the CaP coatings: either cyclic adenosine monophosphate (cAMP) or dexamethasone (Dex). Twenty four cylindrical titanium implants (n = 6/group) were inserted bilaterally into the femoral epiphyses of New Zealand White, female, adult rabbits for 4 weeks. Implant stability was measured by resonance frequency analysis (RFA) the day of implantation and 4 weeks later, and correlated to histomorphometric parameters, bone implant contact (BIC) and bone growth around the implants (BS/TS 0.5 mm). The BIC values for the four groups were not significantly different. That said, histology indicated that the CaP coatings improved bone growth around the implants. The incorporation of bioactive molecules (cAMP and Dex) into the CaP coatings did not improve bone growth compared to the BE group. Implant stability quotients (ISQ) increased in each group after 4 weeks of healing but were not significantly different between the groups. A good correlation was observed between ISQ and BS/TS 0.5 mm indicating that RFA is a non-invasive method that can be used to assess the osseointegration of implants. In conclusion, the CaP coating enhanced bone formation around the implants, which was correlated to stability measured by resonance frequency analysis. Furthers studies need to be conducted in order to explore the benefits of incorporating bioactive molecules into the coatings for peri-implant bone healing.     

Comparison of imaging methods used for dental implant osseous integration assessment

Two different imaging techniques used to determine bone tissue response to dental implants were compared. Dental implants were implanted into the maxillae of 18 pigs, which were sacrificed after 4, 8 and 12 weeks. Implants with surrounding bone tissue were retrieved for methyl methacrylate histology and contact radiography. On identical sections peri-implant bone density and bone implant contact (BIC) ratio were assessed with two different imaging methods. Evaluation of Giemsa eosin stained and contact radiographed sections showed direct osseous integration for all implants and both methods showed a strong correlation with correlation coefficient r = 0.930 (P < 0.0001) for peri-implant bone density and r = 0.817 (P < 0.0001) for bone implant contact ratio. While the two imaging methods showed moderate differences for peri-implant bone density there were significant differences between the BIC values determined. In general, contact radiography tends to underestimate BIC for approximately 4.5 % (P = 0.00003).     

In vivo osseointegration of dental implants with an antimicrobial peptide coating

This study aimed to evaluate the in vivo osseointegration of implants with hydrophobic antimicrobial GL13K-peptide coating in rabbit femoral condyles by micro-CT and histological analysis. Six male Japanese Rabbits (4 months old and weighing 2.5?kg each) were included in this study. Twelve implants (3.75?mm wide, 7?mm long) were randomly distributed in two groups, with six implants in the experimental group coated with GL13K peptide and six implants in the control group without surface coating. Each implant in the test and the control group was randomly implanted in the left or right side of femoral condyles. On one side randomly-selected of the femur, each rabbit received a drill that was left without implant as control for the natural healing of bone. After 3?weeks of healing radiographic evaluation of the implant sites was taken. After 6?weeks of healing, rabbits were sacrificed for evaluation of the short-term osseointegration of the dental implants using digital radiography, micro-CT and histology analysis. To perform evaluation of osseointegration, implant location and group was double blinded for surgeon and histology/radiology researcher. Two rabbits died of wound infection in sites with non-coated implants 2?weeks after surgery. Thus, at least four rabbits per group survived after 6?weeks of healing. The wounds healed without suppuration and inflammation. No implant was loose after 6?weeks of healing. Radiography observations showed good osseointegration after 3 and 6?weeks postoperatively, which proved that the tissues followed a natural healing process. Micro-CT reconstruction and analysis showed that there was no statistically significant difference (P?>?0.05) in volume of bone around the implant between implants coated with GL13K peptide and implants without coating. Histomorphometric analysis also showed that the mineralized bone area was no statistically different (P?>?0.05) between implants coated with GL13K peptide and implants without coating. This study demonstrates that titanium dental implants with an antimicrobial GL13K coating enables in vivo implant osseointegration at similar bone growth rates than gold-standard non-coated dental implants up to 6?weeks of implantation in rabbit femurs.     

Bone tissue response to titanium implant surfaces modified with carboxylate and sulfonate groups

The present study assessed in vivo new bone formation around titanium alloy implants chemically grafted with macromolecules bearing ionic sulfonate and/or carboxylate groups. Unmodified and grafted Ti–6Al–4V exhibiting either 100% carboxylate, or 100% sulfonate, or both carboxylate and sulfonate groups in the percent of 50/50 and 80/20 were bilaterally implanted into rabbit femoral condyle. Neither toxicity nor inflammation were observed for all implants tested. After 4 weeks, peri-implant new bone formation varied as a function of the chemical composition of the titanium surfaces. The percent bone-implant contact (BIC) was the lowest (13.4 ± 6.3%) for the implants modified with grafted carboxylate only. The value of BIC on the implants with 20% sulfonate (24.6 ± 5.2%) was significantly (P < 0.05) lower than that observed on 100% sulfonate (38.2 ± 13.2%) surfaces. After both 4 and 12 weeks post-implantation, the BIC value for implants with more than 50% sulfonate was similar to that obtained with the unmodified Ti–6Al–4V. The grafted titanium alloy exhibiting either 100% sulfonate or carboxylate and sulfonate (50% each) groups promoted bone formation. Such materials are of clinical interest because, they do not promote bacteria adhesion but, they support new bone formation, a condition which can lead to osseointegration of bone implants while preventing peri-implant infections.     

The effects of early osseointegration in different implant sites in rabbit tibias

The aim of this study was to evaluate the early osseointegration of implants with the same surface treatment in different implant sites in rabbit tibias after 4 weeks. A total of 42 acid-etched implants were implanted in three different sites in the tibia: group A was 2.08 ± 0.18 mm below epiphyseal line; group B was 7.00 ± 0.61 mm below the epiphyseal line; group C was 13.01 ± 1.26 mm below the epiphyseal line. After 4 weeks, the average bone-to-implant contact (BIC) values were as follows: group A, 40.02 ± 4.82 %; group B, 28.20 ± 5.41 %; group C, 20.76 ± 3.10 %. The BIC measurements yielded statistically significant differences among group A, group B and group C (P < 0.01); group A demonstrated the best osseointegration. In the present study, the different implantation sites in the selected 20-mm area demonstrated different early osseointegration; the sites located 7 ± 1.5 mm below the epiphyseal line were best suited for observing the effectiveness of early osseointegration among the three sites. The statistical results of the early osseointegration of implants are therefore affected by the location of the implant sites in this 20-mm area.     

Osseointegration of titanium implants functionalised with phosphoserine-tethered poly(epsilon-lysine) dendrons: a comparative study with traditional surface treatments in sheep

The aim of this study was to analyse the osseointegrative potential of phosphoserine-tethered dendrons when applied as surface functionalisation molecules on titanium implants in a sheep model after 2 and 8 weeks of implantation. Uncoated and dendron-coated implants were implanted in six sheep. Sandblasted and etched (SE) or porous additive manufactured (AM) implants with and without additional dendron functionalisation (SE-PSD; AM-PSD) were placed in the pelvic bone. Three implants per group were examined histologically and six implants were tested biomechanically. After 2 and 8 weeks the bone-to-implant contact (BIC) total values of SE implants (43.7 ± 12.2; 53.3 ± 9.0 %) and SE-PSD (46.7 ± 4.5; 61.7 ± 4.9 %) as well as AM implants (20.49 ± 5.1; 43.9 ± 9.7 %) and AM-PSD implants (19.7 ± 3.5; 48.3 ± 15.6 %) showed no statistically significant differences. For SE-PSD and AM-PSD a separate analysis of only the cancellous BIC demonstrated a statistically significant difference after 2 and 8 weeks. Biomechanical findings proved the overall increased stability of the porous implants after 8 weeks. Overall, the great effect of implant macro design on osseointegration was further supported by additional phosphoserine-tethered dendrons for SE and AM implants.     

In vivo assessment of the effect of controlled high- and low-frequency mechanical loading on peri-implant bone healing

The aim of this study was to investigate the effect of controlled high- (HF) and low-frequency (LF) mechanical loading on peri-implant bone healing. Custom-made titanium implants were inserted in both tibiae of 69 adult Wistar rats. For every animal, one implant was loaded by compression through the axis of tibia (test), whereas the other one was unloaded (control). The test implants were randomly distributed among four groups receiving different loading regimes, which were determined by ex vivo calibration. Within the HF (40 Hz) or LF (2 Hz) loading category, the magnitudes were chosen as low- (LM) and high-magnitude (HM), respectively, leading to constant strain rate amplitudes for the two frequency groups. This resulted in the four loading regimes: (i) HF-LM (40 Hz–0.5 N); (ii) HF-HM (40 Hz–1 N); (iii) LF-LM (2 Hz–10 N); and (iv) LF-HM (2 Hz–20 N) loading. Loading was performed five times per week and lasted for one or four weeks. Tissue samples were processed for histology and histomorphometry (bone-to-implant contact, BIC; and peri-implant bone fraction, BF) at the cortical and medullar level. Data were analysed statistically with ANOVA and paired t-tests with the significance level set at 0.05. For the one-week experiments, an increased BF adjacent to the implant surface at the cortical level was exclusively induced by the LF-HM loading regime (2 Hz–20 N). Four weeks of loading resulted in a significant effect on BIC (and not on BF) in case of HF-LM loading (40 Hz–0.5 N) and LF-HM loading (2 Hz–20 N): BIC at the cortical level significantly increased under both loading regimes, whereas BIC at the medullar level was positively influenced only in case of HF-LM loading. Mechanical loading at both HF and LF affects osseointegration and peri-implant BF. Higher loading magnitudes (and accompanying elevated tissue strains) are required under LF loading to provoke a positive peri-implant bone response, compared with HF loading. A sustained period of loading at HF is needed to result in an overall enhanced osseointegration.     

Histomorphometric evaluation of an implant with a nanotubular surface treatment in a beagle femur

This study examined the effects of a nanotubular surface treatment on an implant by anodic oxidation. Forty two screw-shaped implants were classified into 3 groups; machined surface (control group), nanotube formation on the machined surface (group N) and nanotube formation on the RBM surface (group RN). A total of 36 implants were inserted into a beagle femur. Two implants from each group were observed by scanning electron microscopy. Histomorphometric analyses were performed after 4 and 12 weeks. After 4 weeks, the average bone to implant contact (BIC) ratio of groups N and RN was significantly higher than that of the control group (P < .05). After 12 weeks, a nanotubular surface treatment showed a significantly higher BIC ratio only in the marrow space adjacent to the implant apex (P < .05). This in vivo study revealed the enhanced osseointegration of nanotubes.     

A histomorphometric study on osteoconduction and osseointegration of titanium alloy with and without plasma-sprayed hydroxyapatite coating using back-scattered electron images

A quantitative evaluation, at the scanning electron microscopic (SEM) level, was made of the osteoconduction and osseointegration of Ti-6AI-4V implants with and without plasma-sprayed hydroxyapatite coatings (HACs). By employing the Chinese Coin implant model in the lateral femora cortices of canines, different biological properties between HA-coated and uncoated Ti-6AI-4V implants could be compared in one specimen. After 4, 6 and 12 weeks, the implants with surrounding bone were removed and assessed histologically in undecalcified sections under SEM. The osteoconductivity and the ability of osseointegration of implants were histomorphometrically analysed from back-scattered electron images (BEIs) and represented in terms of the new bone healing index (NBHI) and apposition index (AI), respectively. Throughout all implant periods, the HA-coated Ti-6AI-4V implants revealed higher NBHI than the uncoated ones, it appearing that the HA-coated Ti-6AI-4V implants revealed more osteoconductive than the Ti-6AI-4V was. For HA-coated implant, the evidence of direct bone-to-HAC contact was observed. However, at the bone/Ti-6AI-4V interface, there intervened a fibrous membrane without calcium content, indicating that the Ti-6AI-4V implant was not osseointegrated in the SEM field of view. The maximum value of AI was reached 6 weeks after implantation for HA-coated implant, implying that the HAC had a stimulating influence on bone apposition within 6 weeks of healing. The signs of partial dissolution of HACs within the remodelling canals were evident at the HAC-bone interface 12 weeks after implantation, accounting for the slight decrease in NBHI and the obvious decrease in AI for HAC implant.     

A histological and histomorphometrical evaluation of screw-type calciumphosphate (Ca-P) coated implants; an in vivo experiment in maxillary cancellous bone of goats

The bone response to different calcium phosphate (Ca-P) coated implants was evaluated in a goat animal model. Two types of plasma spray coatings were applied to a commercially pure titanium (cpTi) tapered, conical screw-design implant (BioComp^®); hydroxyapatite (HA-PS) and a dual coating, consisting of FA and HA (FA/HA-PS). In addition an amorphous RF magnetron sputter coating (Ca-P-a) and uncoated implants were investigated. Forty-eight implants were inserted in the maxilla of 12 adult female goats. After implantation periods of 3 and 6 months, the bone implant interface was evaluated histologically and histomorphometrically. After both implantation periods all plasma spray coated implants were maintained. On the other hand three Ca-P-a and two cpTi implants were lost. Histological examination revealed a better bone response to both plasma spray coated implants. Histomorphometrical evaluation confirmed this finding. At 3 and 6 months significantly higher percentages of bone contact (p<0.001, ANOVA) were measured for both plasma spray coated implants than for the cpTi and Ca-P-a implants, while no significant difference (p<0.05) existed between both implantation periods. Degradation of both plasma spray coatings was observed. Supported by the results, it is concluded that, although Ca-P coatings can improve the performance of dental implants, the presence of a Ca-P coating is not the only important factor for bone healing around implants placed in low density trabecular bone.     

Effect of biological implant surface coatings on bone formation, applying collagen, proteoglycans, glycosaminoglycans and growth factors

Objectives The aim of the present study was to evaluate six different implant surface coatings with respect to bone formation. Being major structural components of the extracellular matrix, collagen, the non-collagenous components decorin/chondroitin sulphate (CS) and the growth factors TGF-β1/BMP-4 served in different combinations as coatings of experimental titanium implants. Materials and methods Eight miniature pigs received each six implants in the mandible. The implant design showed two circular recesses along the length axis. Three, four, five and six weeks after implant placement, the animals were sacrificed in groups of two. Bone-implant contact (BIC) was evaluated along the outer implant surface and within the recesses. Bone volume was determined by synchrotron radiation micro computed tomography (SRμCT) for one implant of each surface state, 6 weeks after placement. Results At each week of observation, collagen/CS or collagen/CS/BMP-4 coated implants showed the highest BIC of all surface states. This was statistically significant at week five (p = 0.030, p = 0.040) and six (p = 0.025, p = 0.005). SRμCT measurements determined the highest bone volume for a collagen/CS coated implant. Conclusion The results indicate that collagen/CS and collagen/CS/BMP-4 lead to a higher degree of bone formation compared to other ECM components.     

Effect of surface structure on biomechanical properties and osseointegration

The purpose of this study is to improve the bone-bonding ability between titanium implants and living bone through the control of geometric design and chemical compositions of an implant surface. We compared the tissue healing response and resulting implant stability for three surface designs by characterizing the histological and mechanical properties of the healing tissue around smooth-surfaced Ti–6Al–4V (SS), CP-Ti plasma-spray-coated (PSC), alkali- and heat-treated (AHT) implants. The implants were transversely inserted into a dog thighbone and evaluated at 4, 8, and 12 weeks. Histological examination indicated that initial matrix mineralization leading to osseointegration occurred more rapidly with the AHT implant. During the 4, 8, and 12 week healing periods, new bone on the surface of AHT implant showed denser growth than that on the SS and PSC implants. The more extensive tissue integration and more rapid matrix mineralization with the AHT implant were reflected in the mechanical test data, which demonstrated superior attachment strength and interfacial stiffness for the AHT implant after healing for 4, 8 and 12 weeks of healing because of the mechanical interlocking in the micrometer sized rough surface and the large bonding area between bone and implant caused by the nanosized porous surface structure. Histological and mechanical data demonstrate that with the appropriate surface design selection, bone bone-bonding ability can be improved and can induce acceleration of the healing response, thereby improving the potential for implant osseointegration.     

Unravelling the effect of macro and microscopic design of dental implants on osseointegration: a randomised clinical study in minipigs

Several dental implants are commercially available and new prototype design are constantly being fabricated. Nevertheless, it is still unclear what parameters of the design affect most the osseointegration of dental implants. The purpose of this study is to assess the effects of the microscopic and macroscopic design of dental implants in the osseointegration by comparing three macroscopic designs (Straumann tissue level (STD), essential cone (ECD) and prototype design (PD)) and six surface treatments. A total of 96 implants were placed in 12 minipigs. The implant stability quotient (ISQ), was assessed at the time of implantation, as well as at 2, 4 and 8 weeks. Histomorphometric and statistical analyses were conducted at the different sacrifice times, being 2, 4 and 8 weeks, to analyse the bone to implant contact (BIC), the bone area density (BAT) and the density of bone outside the thread region (ROI). The macroscopic design results showed higher ISQ values for the ECD, whereas the histomorphometric analysis showed higher ossoeintegration values for the STD. Regarding the microscopic design, both Sandblasted plus acid etching (hydrochloric/sulphuric acid) in a nitrogen atmosphere (SLActive) and Shot-blasted or bombarded with alumina particles and posterior alkaline immersion and thermal treatment (ContacTi) showed superior results in terms of osseointegration and reduced the osseointegration times from 8 weeks to 4 weeks compared to the other analysed surfaces. In conclusion, each of the macroscopic and microscopic designs need to be taken into account when designing novel dental implants to enhance the osseointegration process.     

Osseointegration of Titanium Implants by Addition of Recombinant Bone Morphogenetic Protein 2 (rhBMP‐2)

The osseointegration of long‐term implants is often incomplete such that gaps remain between the implant surface and the surrounding hard tissue. This study examines the effect of soluble recombinant human bone morphogenic protein 2 (rhBMP‐2) on gap healing and osseous integration. The effect of a single, intraoperative application of soluble rhBMP‐2 on the formation of new bone around titanium implants was studied. A total of 8 titanium‐alloy cylinders (Ti‐6Al‐4V) with a plasma spray coating (TPS; 400 μm thickness) were implanted into femoral condyles of mature sheep: rhBMP‐2 solution (1 μg) was pipetted into the 1 mm wide cleft around 4 implants; 4 further implants served as rhBMP‐2‐free controls. Two of these controls exhibited an additional calciumphosphate‐coating. The cleft around the implants served as testing zone to study the formation of new bone by microradiographical and histological analyses. The follow‐up periods were 4 and 9 weeks, respectively. A significant amount of new bone contacting the implants' surface was detected where rhBMP‐2‐solution had been used: In 50% a circumferential osseoinduction occurred within 4 weeks and a nearly complete osseointegration was observed after 9 weeks. In all cases bone formation was exaggerated and filled the spongiosa with compact bone. Time matched TPS‐controls and controls with calciumphosphate coating showed no notable formation of new bone. The results suggest that a single administration of soluble rhBMP‐2 into a bone cavity can augment bone formation and also osseointegration of titanium implants. Further investigations based on these findings are necessary to develop long‐term implants (e. g. joint replacements) with rhBMP‐2‐biocoating for humans.     

Histomorphometric study of bone reactions with different hydroxyapatite coating thickness on dental implants in dogs

The purpose of this study was to evaluate the effects of different hydroxyapatite (HA) coating thicknesses on osseointegration after dental implantation in dogs. Six dogs, weighing 10-15 kg, were used in this study. The fixtures, with HA coatings of different thicknesses and made by Dentis, were implanted for 12 weeks in right iliac crestal bone sites and for 6 weeks in left iliac crestal bone sites. Implants in the control group were coated with resorbable blast medium, whereas those in the experimental group were coated with HA of different thicknesses (1, 5, and 15 μm). All dogs were sacrificed at 12 weeks after implant placement, and histological and histomorphometric analyses were performed. The implants were all successful, and a significant difference between the control and experiment groups was observed at 6 weeks, although no significant difference between the control and experimental groups was seen at 12 weeks. These results suggested that HA implant coating may positively affect early osseointegration, but coating thickness had no significant effect on ultimate osseointegration.     

Evaluation of trabecular bone formation in a canine model surrounding a dental implant fixture immobilized with an antimicrobial peptide derived from histatin

JH8194 induces osteoblast differentiation, although it was originally designed to improve antifungal activity. This suggests that JH8194 is useful for implant treatment. Therefore, the aim of this study was to evaluate the osseointegration capacity of JH8194-modified titanium dental implant fixtures (JH8194-Fi). The implants were randomly implanted into the edentulous ridge of dog mandibles. Healing abutments were inserted immediately after implant placement. Three weeks later, peri-implant bone levels, the first bone-to-implant contact points, and trabecular bone formation surrounding the implants were assessed by histological and digital image analyses based on microcomputed tomography (microCT). The histological analysis revealed an enhancement of mature trabecular bone around the JH8194-Fi compared with untreated fixtures (control-Fi). Similarly, microCT combined with analysis by Zed View? also showed increased trabecular bone formation surrounding the JH8194-Fi compared with the control-Fi (Student's t-test, P < 0.05). JH8194 may offer an alternative biological modification of titanium surfaces to enhance trabecular bone formation around dental implants, which may contribute to the transient acquirement of osseointegration and the long-term success of implant therapy.     

Fabrication of an rhBMP-2 loaded porous β-TCP microsphere-hyaluronic acid-based powder gel composite and evaluation of implant osseointegration

Methods to improve osseointegration that include implantation of rhBMP-2 with various kinds of carriers are currently of considerable interest. The present study was conducted to evaluate if the rhBMP-2 loaded β-TCP microsphere-hyaluronic acid-based powder-like hydrogel composite (powder gel) can act as an effective rhBMP-2 carrier for implantation in host bone with a bone defect or poor bone quality. The release pattern for rhBMP-2 was then evaluated against an rhBMP-2-loaded collagen sponge as a control group. Dental implants were also inserted into the tibias of three groups of rabbits: an rhBMP-2 (200 µg) loaded powder gel composite implanted group, an implant only group, and a powder gel implanted group. Micro-CT and histology of the implanted areas were carried out four weeks later. The rhBMP-2 powder gel released less rhBMP-2 than the collagen sponge, but it continued a slow release for more than 7 days. The rhBMP-2 powder gel composite improved osseointegration of the dental implant by increasing the amount of new bone formation in the implant pitch and it improved the bone quality and bone quantity of new bone. The histology results indicated that the rhBMP-2 powder gel composite improved the osseointegration in the cortical bone as well as the marrow space along the fixture. The bone-to-implant contact ratio of the rhBMP-2 (200 µg) loaded powder gel composite implanted group was significantly higher than those of the implant only group and the powder gel implanted group. The powder gel appeared to be a good carrier and could release rhBMP-2 slowly to promote the formation of new bone following implantation in a bone defect, thereby improving implant osseointegration.     

Histomorphometric and histologic evaluation of titanium–zirconium (<Emphasis Type="Italic">a</Emphasis>TiZr) implants with anodized surfaces

The choice of implant surface has a significant influence on osseointegration. Modification of TiZr surface by anodization is reported to have the potential to modulate the osteoblast cell behaviour favouring more rapid bone formation. The aim of this study is to investigate the effect of anodizing the surface of TiZr discs with respect to osseointegration after four weeks implantation in sheep femurs. Titanium (Ti) and TiZr discs were anodized in an electrolyte containing dl-α-glycerophosphate and calcium acetate at 300 V. The surface characteristics were analyzed by scanning electron microscopy, electron dispersive spectroscopy, atomic force microscopy and goniometry. Forty implant discs with thickness of 1.5 and 10 mm diameter (10 of each-titanium, titanium–zirconium, anodized titanium and anodized titanium–zirconium) were placed in the femoral condyles of 10 sheep. Histomorphometric and histologic analysis were performed 4 weeks after implantation. The anodized implants displayed hydrophilic, porous, nano-to-micrometer scale roughened surfaces. Energy dispersive spectroscopy analysis revealed calcium and phosphorous incorporation into the surface of both titanium and titanium–zirconium after anodization. Histologically there was new bone apposition on all implanted discs, slightly more pronounced on anodised discs. The percentage bone-to-implant contact measurements of anodized implants were higher than machined/unmodified implants but there was no significant difference between the two groups with anodized surfaces (P > 0.05, n = 10). The present histomorphometric and histological findings confirm that surface modification of titanium–zirconium by anodization is similar to anodised titanium enhances early osseointegration compared to machined implant surfaces.     

Nanoscale characterization of bone–implant interface and biomechanical modulation of bone ingrowth

Bone–implant interface is characterized by an array of cells and macromolecules. This study investigated the nanomechancial properties of bone–implant interface using atomic force microscopy in vitro, and the mechanical modulation of implant bone ingrowth in vivo using bone histomorphometry. Upon harvest of screw-type titanium implants placed in vivo in the rabbit maxilla and proximal femur for 4 weeks, nanoindentation was performed in the bone–implant interface at 60-μm intervals radially from the implant surface. The average Young's Moduli (E) of the maxillary bone–implant interface was 1.13 ± 0.27 MPa, lacking significant differences at all intervals. In contrast, an increasing gradient of E was observed radially from the femur bone–implant interface: 0.87 ± 0.25 MPa to 2.24 ± 0.69 MPa, representing significant differences among several 60-μm intervals. In a separate experiment, bone healing was allowed for 6 weeks for proximal femur implants. The right femoral implant received axial cyclic loading at 200 mN and 1 Hz for 10 min/d over 12 days, whereas the left femoral implant served as control. Cyclic loading induced significantly higher bone volume, osteoblast numbers per endocortical bone surface, mineral apposition rate, and bone formation rate than controls. These data demonstrate nanoscale and microscale characterizations of bone–implant interface, and mechanical modulation of bone ingrowth surrounding titanium implants.     

Titanium dental implants coated with Bonelike®: Clinical case report

The aim of the study was to evaluate the direct bone bonding and osteointegration of the commercial pure (cp Ti) implants coated with Bonelike® synthetic bone graft by plasma spraying. The Bonelike® coated implant was placed in the mandible of a 40-year-old patient and it was removed after a healing period of 3 months with a trephine of 6 mm diameter. The structure of the coating and new bone/implant interface of retrieved samples were evaluated using scanning electron microscopy (SEM) and histological analysis using light microscopy. In vivo microstructure observations of Bonelike® coated retrieved implants showed excellent bone remnants on its surface without any tissue and inflammatory signs observed. The reported Bonelike® coated (cp Ti) implants improved primary stability, which may increase the lifetime of the implant. Bonelike® coated dental implants proved to be highly bioactive with extensive new bone formation and strongly bonded to Bonelike® coating.