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PubMed1998

Tensile tests of interface between bone and plasma-sprayed HA coating-titanium implant.

Tensile strength testing of the interface between bone and a plasma-sprayed hydroxyapatite (HA) coating-Ti-6Al-4V (implant I) and an HA coating-Ti (implant II) was performed. The bone-implant interface and tensile failure mode were evaluated by light microscopy (LM), SEM-energy dispersive X-ray analysis, and backscattered electron imaging. The crystallinity of the HA coating of implant I and implant II was 62 and 40%, respectively. Eleven semidisk implants of each type were inserted in the left tibia of 22 rabbits in each period. After 2, 4, 8, and 16 weeks, the tensile strength of the bone-implant I was 0.86, 1.32, 1.10, and 0.92 MPa, respectively; the value of the bone-implant II was 0.66, 0.92, 0.84, and 1.12 MPa, respectively. No significant difference was found in tensile strength between implant I and implant II, and between the data of different periods. LM and SEM revealed that the two types of coatings behave the same in bone. Failure after the tensile test mainly occurred at the bony tissue at 2 and 4 weeks, inside the HA coating layer at 8 weeks, and at the HA coating-metal substrate interface at 16 weeks. Degradation and delamination of the HA coating continued with time, resulting in the interfacial tensile strength not increasing with time. Thus, we concluded that differences between the two implants, mainly the difference in crystallinity of the HA coating (62 vs. 40%), have no significant influence on bone bonding ability, bone bonding strength, tensile failure mode, and degradation of the coating.

Animals↗

PubMed1991

Characterization of the interface in the plasma-sprayed HA coating/Ti-6Al-4V implant system.

The successful use of plasma-sprayed hydroxyapatite (HA) coatings on Ti-alloy implants for implant-to-bone fixation requires strong adherence of the ceramic coating to the underlying metal substrate. In this study, the metal-ceramic interface was evaluated using mechanical, chemical, and structural characterization methods. Evaluations of an HA-coated Ti-6Al-4V implant system using a modified short bar technique for interfacial fracture toughness determination revealed relatively low fracture toughness values. Additionally, conventional tensile bond strength testing indicated much lower values than previously reported. Using high resolution electron spectroscopic imaging, evidence of chemical bonding was revealed at the plasma-sprayed HA/Ti-6Al-4V interface, though bonding was primarily due to mechanical interlock at the interface. This study illustrates the benefits of, and the need for, a multilevel approach to evaluate and improve these plasma-sprayed ceramic-metal substrate interfaces.

Alloys↗

PubMed1995

Adsorption of human salivary proteins to titanium powder. I. Adsorption of human salivary albumin.

Titanium (Ti) is among the most widely used implant materials in dentistry today. The success of Ti implants is associated with their interactions with the surrounding tissues and biological fluids. In the present study, the adsorption of salivary proteins to Ti and the effect of calcium (Ca) on this process were investigated. Untreated and Ca-treated Ti powders were suspended in human clarified whole saliva. After incubation, the supernatant fluid was collected for protein analysis. The powders were then washed and resuspended in EDTA to desorb proteins from Ti surfaces. Sodium dodecylsulphate polyacrylamide gel electrophoresis and Bradford protein assay were conducted to determine the concentration and type of proteins that adsorbed onto Ti surfaces. The presence of Ca ions enhanced the adsorption of salivary proteins to Ti. A 66 kDa protein, identified by immunoblotting as albumin, was found as the main adsorbed salivary protein. Adsorption of albumin to Ti pretreated with Ca was significantly greater than to native Ti. The Ca-dependent adsorption process was reversed by EDTA. The data suggest that salivary albumin is one of the main constituents of a salivary biofilm formed on Ti dental implants and its adsorption to Ti surfaces is Ca-dependent. The presence of albumin on Ti dental implants may affect plaque accumulation on the implants and the biocompatibility of Ti implants.

Adsorption↗

PubMedDate not supplied

Characterization of bone around titanium implants and bioactive glass particles: an experimental study in rats.

PURPOSE: Many situations in clinical practice require metallic implants to be combined with bone grafts and/or bone substitutes such as bioactive glass (BG). Upon implantation, silica-based BG particles are transformed into a shell containing calcium and phosphate that loses its inner silicon-rich core. The release of silicon by BG particles and its incorporation by newly formed bone tissue in the peri-implant area had not been studied to date. MATERIALS AND METHODS: Thirty Wistar rats were used throughout. Under anesthesia, a commercially pure titanium (Ti) laminar implant was placed inside the medullary compartment of the tibia (Ti group), while in the contralateral tibia (Ti/BG group) a titanium laminar implant and melt-derived BG 45S5 particles were implanted. The animals were sacrificed 14, 30, and 60 days postimplantation. The tibiae were resected, radiographed, and embedded in methyl methacrylate resin. Sections were stained with toluidine blue and analyzed by light microscopy and energy-dispersive x-ray analysis (EDX). The presence of silicon, calcium, and phosphorus was evaluated in the BG particles and in the peri-implant bone tissue for each of the experimental times. RESULTS: The histomorphometric study revealed an increase in peri-implant bone thickness in the Ti/BG group as compared to the Ti group. EDX of newly formed bone tissue showed a transient appearance of silicon at 14 and 30 days postimplantation and a rise in the calcium:phosphorus ratio in peri-implant bone tissue in the Ti/BG group. DISCUSSION: The present study shows an increase in reactive medullary bone formation when BG particles are implanted around a Ti implant. CONCLUSION: The results described in the present study reveal that the release of Si by BG particles is an important issue that warrants further study.

Animals↗

PubMed2001

Tissue response to hafnium.

The aim of the present experimental study was to evaluate the tissue response to hafnium (Hf) a reactive metal closely related to titanium (Ti) and zirconium (Zr). Hf has not been previously evaluated as implant material in a biologic environment. In a first experiment, 21 machined Hf non-threaded implants (test) and 21 similar Ti implants (control) were inserted in the abdominal wall of 21 rats. Animals were sacrificed after 8 days (6 rats), 6 (7 rats) and 12 weeks (8 rats). In a second experiment, 18 rabbits received 18 Hf and 18 Ti threaded implants in their tibiae, one implant in each tibia. The rabbits were sacrificed after 6, 12 and 24 weeks (6 animals/time interval). The bulk metal of the abdominal wall implants, embedded together with the surrounding tissue, was electrolytically dissolved and semithin (1 microm) sections of the intact tissue-implant interface were evaluated by light microscopy (morphometry). Bone-implant contact and bone area within threads were evaluated in ground sections. In soft tissues, a fluid space containing predominantly monocytes/macrophages surrounded the abdominal implants at 8 days. At 6 and 12 weeks, a fibrous capsule, consisting of layers of macrophages and fibroblasts, surrounded the implants. Macrophages, including multinuclear giant cells, always formed the innermost layer in contact with the implant surface. No quantitative or qualitative difference in the tissue organization was detected between Ti and Hf implants. In rabbits, 6 weeks after insertion, the proximal two threads located within the cortical bone were filled with bone in contact with Hf and Ti. The distal threads contained bone marrow. After 12 and 24 weeks, mature bone was present in the proximal 3-4 implant threads. No statistically significant difference was found between Hf and Ti implants at any time periods. It is concluded that Hf is an interesting metal for biomedical applications in bone and soft tissue.

Journal Article↗

PubMed2001

Loading improves anchorage of hydroxyapatite implants more than titanium implants.

Roentgen Stereophotogrammetric Analysis (RSA) studies have shown that the quality of the early fixation of implants has a dominant effect on their long-term function. To evaluate methods to improve their fixation, we examined the influence of mechanical loading and surface coating on the quality of the bone-implant interface. We compared the fixation of a cylindrical, stable 6.0 mm implant initially surrounded by a 0.75 mm concentric gap, after 4 weeks of loaded or unloaded conditions. Two types of surfaces were analyzed: plasma sprayed hydroxyapatite (HA) and plasma sprayed titanium (Ti). The histomorphometric evaluation showed that HA implants had greater bone coverage than Ti implants, and this coverage was further increased under loaded conditions only for HA. Furthermore, loading reduced the fibrous tissue coverage for the HA implants, while it increased fibrous tissue coverage for Ti implants. These findings were in agreement with pushout results showing that HA implants had greater shear strength, stiffness, and energy than Ti implants, and (except for energy) these parameters were further increased under loaded conditions only for HA. In addition, because the two implant surfaces exhibited a different relative response to load, it is important to evaluate new surfaces under the more clinically relevant loaded condition.

Animals↗

PubMed2003

Ten-year follow-up of primary straight-stem prosthesis (MEM) made of titanium or cobalt chromium alloy.

INTRODUCTION: An increased revision rate of cemented titanium stems compared with cobalt chromium stems has been described after a short follow-up. In this paper, the minimum 10-year outcome after the implantation of titanium (Ti) and cobalt chromium ME (CoCr) Mueller straight-stem prostheses is analyzed in order to estimate the prognosis of the patients who were not revised. MATERIALS AND METHODS: . A total of 272 (Ti) straight stems were implanted between 1987 and 1990, and 161 (CoCr) straight stems were implanted from 1984 to 1987. Clinical and radiological checks were carried out prospectively after 1, 2, 5, and 10 years. RESULTS: The survival rate concerning aseptic loosening of the stem after 5 years was 92.8% (Ti)/100% (CoCr) and after 10 years 80.9%/98.2%. Thirty-six (Ti)/2 (CoCr) patients required revision of the stem due to aseptic loosening. The revision rate per year of the Ti stems increased until 7 years postoperatively and decreased thereafter. At the 10-year follow-up, 107 Ti and 84 CoCr implants were checked, and the subjective and clinical parameters did not differ between the two groups. CONCLUSION: Except for an increased subsidence rate of the stems in the Ti (31%) versus the CoCr group (16%), there was no statistically significant difference in the clinical and radiological outcomes.

Aged↗

PubMed1997

Biomaterials for orthopedic surgery in osteoporotic bone: a comparative study in osteopenic rats.

UNLABELLED: To evaluate orthopedic devices in pathological bone, an experimental study was performed by implanting Titanium (Ti) and Hydroxyapatite (HA) rods in normal and osteopenic bone. Twenty-four rats were used: 12 were left intact ( CONTROL: C) while the other 12 were ovariectomized (OVX). After 4 months all the animals were submitted to the implant of Ti or HA in the left femoral condyle (Ti-C, HA-C, Ti-OVX, HA-OVX). Two months later the animals were sacrificed for histomorphometric, ultrastructural and microanalytic studies. Our results show a significant difference between the Affinity Index (A.I.) of HA-C and Ti-C (77.0 +/- 7.4 vs 61.2 +/- 9.7) (p < 0.05). No significant differences were observed between the osteointegration of Ti-C and Ti-OVX (61.2 +/- 9.7 vs 48.2 +/- 6.7). Significant differences also exist between the osteointegration of HA-C and HA-OVX (77.0 +/- 7.4 vs 57.6 +/- 11.5) (p < 0.01). Microanalysis shows some modifications in Sulphur (S) concentration at the bone/biomaterial interface of the Ti-OVX group. Therefore our results confirmed the importance of biomaterials characteristics and of bone quality in osteointegration processes.

Animals↗

PubMed2002

[Correction of cleft lip nose deformities using Ni-Ti shape memory alloy mesh stent implant].

OBJECTIVE: To demonstrate the feasibility of Ni-Ti shape memory alloy mesh stent for the correction of nasal deformities caused by cleft lip. METHODS: Six patients with cleft lip-nose deformities, aged from 18 to 32, were treated by implantation of Ni-Ti shape memory alloy mesh stent through intra-nasal incisions. RESULTS: The symmetry of the alar and nasal tip were cosmetically acceptable. Satisfactory relationship between the lip and the nose were obtained in all the patients. There were not any postoperative surgical complications by 6 to 12 months' follow-up. CONCLUSION: The Ni-Ti shape memory alloy mesh stent is suitable for use in the correction of adult cleft-lip nose deformities.

Adolescent↗

PubMed1997

Implant-retained mandibular overdentures with immediate loading. A retrospective multicenter study on 226 consecutive cases.

A multicenter retrospective study has been conducted on 226 patients necessitating an implant-supported overdenture in the lower jaw. The patients were provided with 904 osseointegrated implants inserted in the interforaminal area of the mental symphisis (4 implants per patient). 4 titanium implant systems were used: TPS and ITI screw implants (Straumann Institute, Waldenburg, Switzerland); Ha-Ti screw implants (Mathys Dental Implants, Bettlach, Switzerland); NLS screw implants (Friatec, Mannheim, Germany). Immediately after implant placement, a U-shaped gold bar was fabricated and implants were immediately loaded with an implant-retained overdenture. Out of 226 patients treated, 194 were followed from a minimum of 2 years to a maximum of 13 years, with a mean follow-up of 6.4 years, whereas 32 patients dropped out during follow-up. The overall failure rate of implants was 3.1% (24/776 implants), whereas the failure rate of bars was 1.5% (3/194 bars). Results from this study showed that the success rate of immediately loaded implants is similar to that obtained in the case of delayed loading, after osseointegration has taken place. In contrast, this method shortens dental rehabilitation times with relevant satisfaction for patients.

Adult↗

PubMed1993

Wear of the polyethylene acetabular cup. Metallic and ceramic heads compared in a hip simulator.

Ultra-high molecular weight polyethylene acetabular cups of 5 different total hip systems (Müller, Mallory-Head, Lubinus, P.C.A. and Charnley-Elite) were worn on a new 5-station hip joint simulator. The cups articulated against modular metallic (stainless steel in Müller and Charnley-Elite, ion-implanted Ti-6Al-4V in Mallory-Head, and Co-Cr-Mo in Lubinus and P.C.A.) and modular alumina ceramic femoral heads for 3 million walking cycles. The mean wear rate of cups against alumina heads (range 0-5.7 mg/10(6) cycles, corresponding to 0-0.008 mm/year) was usually lower than against metallic heads (range 3.9-178 mg/10(6) cycles, corresponding to 0.005-0.24 mm/year). In the metal-head prostheses, the mean wear rate was highest against stainless steel heads, and lowest against ion-implanted Ti-6Al-4V heads. As the wear rates are compared with published clinical observations, it can be concluded that the hip joint simulator is capable of producing realistic wear rates; it is a useful instrument in the study of the wear behavior of new designs, materials, surface treatments and coatings prior to clinical trials. However, the taper-fit attachment of modular heads proved problematical, showing corrosion and wear at the conical head-spigot interface.

Acetabulum↗

PubMed2004

Predicting graded young modulus values of Ti alloys modified by ion implantation.

There has been, and is still, concern about the high elastic modulus of Ti alloys compared to bone. Any reduction in the Young's modulus value of the implant is expected to enhance stress redistribution to the adjacent bone tissues, minimize stress shielding and eventually prolong device lifetime. Dynamic Monte Carlo simulation is used to predict the gradual reduction in Young's modulus values between the bulk of Ti alloys and the modified surface layers due to Ca ion implantation. The simulation can be used as a screening step when applying new alloys and/or coatings.

Alloys↗

PubMed2002

Osseointegration of hydroxyapatite-coated and noncoated Ti6Al4V implants in the presence of local infection: a comparative histomorphometrical study in rabbits.

A study was designed to investigate the osseointegration of titanium implants, either noncoated or coated with hydroxyapatite (HA), into rabbit tibiae in the presence of local infection compared with osseointegration in the absence of local infection. HA-coated or noncoated Ti cylinders were implanted into both tibiae of 32 rabbits (New Zealand Whites). Before implantation the left tibia was contaminated with different quantities of Staphylococcus aureus (10(2)-10(5) CFU). Four weeks after surgery the tibiae were explanted and prepared for microbiological and histomorphometrical examination. Histomorphometrical data, as a representation of implant fixation, were obtained by measuring the percentage of bone around the implants (within a radius of 1 mm from the outer diameter of the implants) and the percentage of the circumference of the implant that was in direct contact with bone. Histomorphometry revealed, in particular for the HA implants, a relationship between the inoculum concentration and/or the presence or absence of infection with the bone contact at the distal implant side. This confirms a relationship between peri-implant infection and bone contact or remodeling. HA-coated implants developed, in the presence of bacteria, more easily a more severe infection than noncoated Ti implants, and we show in the present study that local infection will influence histomorphometrical parameters (bone-implant contact) that determine implant fixation. Precautions to prevent contamination (asepsis) and/or infection (perioperative antibiotics) are even more important for the highly biocompatible HA-coated implant.

Alloys↗

PubMedDate not supplied

Influence of RGD-loaded titanium implants on bone formation in vivo.

Little is known about the ability of peptide-coated surfaces to influence cell responses in vivo. Many studies have demonstrated that peptide-modified surfaces influence cell responses in vitro. Integrins, which bind specifically short peptide sequences, are responsible for these cell responses. In this way, information can be transmitted to the nucleus through several cytoplasmic signaling pathways. The peptide sequence Arg-Gly-Asp (RGD peptide) plays an important role in osteoblast adhesion. The present study was designed to investigate new bone formation in a porous titanium (Ti) fiber mesh implant, which was coated with cyclic RGD peptide. The RGD-Ti implants were inserted into the cranium of a rabbit and were compared with porous titanium fiber mesh disks without RGD sequence (Ti) and with an open control defect. Histologic and histomorphometric examinations were performed 2, 4, and 8 weeks postoperatively. A significant increase in bone formation, or bone ingrowth, was seen in the RGD-Ti group compared with the Ti group after 4 and 8 weeks. All control defects stayed open in all three periods. It was concluded that the use of cyclic RGD peptide in combination with titanium fiber mesh has a positive effect on bone formation in vivo in a rabbit animal model.

Animals↗

PubMed1993

Extensive porosity at the cement-femoral prosthesis interface: a preliminary study.

This study is the first description of the extensive porosity which is preferentially located at the cement-prosthesis interface of cemented femoral components of total hip replacements. The observation is important because the interfacial porosity may decrease the strength of the cement-femoral prosthesis interface and jeopardize the mechanical integrity of the cement mantle. We examined the cement-metal interfaces from a multiplicity of in vivo and in vitro specimens using both optical and scanning electron microscopy. These samples included several stem designs, implants made from either Co-Cr or Ti alloy, implants made with a variety of surface finishes and both centrifuged and uncentrifuged cement. All in vivo and in vitro samples had marked porosity in the cement focally concentrated at the cement-metal interface. The amount of porosity at the interface greatly exceeded the amount of general porosity found throughout the bulk cement. Centrifuging did not affect the interfacial porosity, and neither did alloy nor surface finish. The presence of these pores may be explained by the rheological characteristics of the cement.

Alloys↗

PubMed2002

Effect of simulated CO2 and GaAlAs laser surface decontamination on temperature changes in Ti-plasma sprayed dental implants.

BACKGROUND AND OBJECTIVE: To investigate and compare temperature elevations at the implant-bone interface during simulated implant surface decontamination with a CO2 and a GaAlAs laser. STUDY DESIGN/MATERIALS AND METHODS: Stepped cylinder implants (Frialit 2) Friadent GmbH, Mannheim, Germany) with a Titanium plasma sprayed surface were inserted into bone blocks cut from pig femurs. An artificial periimplant bone defect provided access for laser irradiation in the coronal third. Both lasers were operated at 1.0-2.5 W in the cw-mode. The bone block was placed into a 37 degrees C water bath in order to simulate in vivo thermal conductivity and diffusitivity of heat. K-type thermocouples connected to a digital meter were used to register temperature changes at the periimplant bone. RESULTS: In mean, the critical threshold of 47 degrees C was exceeded after 8 seconds at a power output of 2.5 W, 13 seconds at 2.0 W, 18 seconds at 1.5 W, and 42 seconds at 1.0 W with the GaAlAs laser and 15 seconds (2.5 W), 23 seconds (2.0 W), 35 seconds (1.5 W), and 56 seconds (1.0 W) with the CO2 laser. At equal energy fluence, GaAlAs laser irradiation induced significantly higher temperature elevations than CO2 laser irradiation. CONCLUSIONS: In an energy dependent manner implant surface decontamination with both laser types must be limited in time to allow the implant and bone to cool down. Clinical guidelines are presented to avoid tissue damage.

Animals↗

PubMedDate not supplied

Microstructures of plasma-sprayed hydroxyapatite-coated Ti-6Al-4V dental implants.

The purpose of this study was to investigate the microstructure of plasma-sprayed hydroxyapatite coatings and the elemental composition near the coating-substrate interface for two commercial implants, using the scanning electron microscope. Both coating surfaces and cross-sectioned specimens were examined. The results indicated that while the surface microstructures of both implants were consistent with the plasma-spraying process, the scale of the constituents was much finer for one product. In cross-section, both coatings exhibited minimal porosity and intimate contact with the titanium alloy substrate. It was found that limited interdiffusion of titanium and calcium occurred near the interface.

Alloys↗

PubMed2003

Corrosion behaviour of commercially pure titanium shot blasted with different materials and sizes of shot particles for dental implant applications.

It is well known that the osseointegration of the commercially pure titanium (c.p. Ti) dental implant is improved when the metal is shot blasted in order to increase its surface roughness. This roughness is colonised by bone, which improves implant fixation. However, shot blasting also changes the chemical composition of the implant surface because some shot particles remain adhered on the metal. The c.p. Ti surfaces shot blasted with different materials and sizes of shot particles were tested in order to determine their topographical features (surface roughness, real surface area and the percentage of surface covered by the adhered shot particles) and electrochemical behaviour (open circuit potential, electrochemical impedance spectroscopy and cyclic polarisation). The results demonstrate that the increased surface area of the material because of the increasing surface roughness is not the only cause for differences found in the electrochemical behaviour and corrosion resistance of the blasted c.p. Ti. Among other possible causes, those differences may be attributed to the compressive residual surface stresses induced by shot blasting. All the materials tested have an adequate corrosion and electrochemical behaviour in terms of its possible use as dental implant material.

Corrosion↗