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Study of bone formation around dense hydroxyapatite implants using light microscopy, image processing and confocal laser scanning microscopy.

The bone reaction to hydroxyapatite (HA) implants inserted transcortically and extending into the medullary canal of rat tibiae was quantitatively assessed using light microscopy, confocal laser scanning microscopy and an image processing system. Sixty-five male rats (6 weeks old) were divided into two groups, 60 for histological observation and image analysis and five for time-labelling. In the histological observation, control sections of 168 days showed a few bone trabeculae in the fatty bone marrow, and Ti implants had become gradually encapsulated with a thick bone tissue layer; however, HA implants became almost completely encapsulated with a thin bone tissue layer during the 168 day experimental period. Histometrical analysis of the percent bone contact revealed that Ti implants showed a continuous increasing curve, and HA implants showed rapid increase in the initial healing period up to 14 days, with 96% bone contact reaching a plateau at 84 days after operation. There was a significant difference in the percent of bone contact between Ti and HA implants throughout the experimental period. Confocal laser scanning microscopic observations revealed the presence of calcein at the 14th day and only slight alizarin colour layer in the bone tissue at the 28th day, both indicating bone formation. These findings suggest that the activity of bone formation was higher at the 14th day than at the 28th day. Also, the percentage of bone contact of HA is superior to titanium throughout the experimental period, and the ascending patterns of both implants are quite different to each other.

Animals↗

Roughness induced dynamic changes of wettability of acid etched titanium implant modifications.

Dynamic contact angle analysis (DCA) was used to investigate time-dependent wettability changes of sandblasted and acid-etched commercially pure (cp) titanium (Ti) implant modifications during their initial contact with aqueous systems compared to a macrostructured reference surface. Surface topography was analyzed by scanning electron microscopy and by contact stylus profilometry. The microstructured Ti surfaces were found to be initially extremely hydrophobic. This hydrophobic configuration can shift to a completely wettable surface behavior with water contact angles of 0 degrees after the first emersion loop during DCA experiments. It is suggested that a hierarchically structured surface topography could be responsible for this unexpected wetting phenomenon. Roughness spatial and hybrid parameters could describe topographical features interfering with dynamic wettability significantly better than roughness height parameters. The Ti modifications which shift very sudden from a hydrophobic to a hydrophilic state adsorbed the highest amount of immunologically assayed fibronectin. The results suggest that microstructuring greatly influences both the dynamic wettability of Ti implant surfaces during the initial host contact and the initial biological response of plasma protein adsorption. The microstructured surfaces, once in the totally wettable configuration, may improve the initial contact with host tissue after implantation, due to the drastically increased hydrophilicity.

Acids↗

Bacterial leakage into and from prefabricated screw-retained implant-borne crowns in vitro.

A mean gap of less than 4 microm following laboratory procedures and continuous loading was demonstrated in prefabricated crowns of the Ha-Ti implant system in earlier studies. The clinical relevance of such high precision in maintaining inflammation free marginal mucosa is yet to be determined. In this present investigation, the complete assembly of Ha-Ti implants including prefabricated screw-retained crowns was tested for bacterial leakage under controlled conditions in vitro. The gaps were shown not to be a barrier for Staphylococcus aureus which were used as test bacteria. Bacterial leakage through these gaps from the environment to the interior of the assembly and vice versa was observed within 24-120 h. The main path of bacterial penetration was possibly found to be through the transversal screw hole and not through the marginal gap of the prefabricated crowns.

Crowns↗

Long-term evaluation of bone-titanium interface in rat tibiae using light microscopy, transmission electron microscopy, and image processing.

We conducted a 2-year histologic and histometric evaluation of the tibial bone-titanium (Ti) implant interface in male rats. Thirty male 6-week-old rats were used in this study. They were divided into two groups: 15 for day 28 and 15 for day 730. Microscopic observation at day 28 revealed that the newly formed bone around the implant almost surrounded the implant, but fibroblastlike cells were interposed in some histologic sections. At day 730, in contrast, such cells were rarely seen, and the bone around the implant presented a lamellar structure. Transmission electron microscopic observation at day 28 disclosed mature or poorly mineralized bone near the implant; however, an electron-dense amorphous zone about 50 nm in thickness was interposed between the bone and Ti. In places slender cells were interposed between the bone and Ti. The amorphous zone was also observed at the cell-Ti interface. At day 730, a poorly mineralized layer remained in some areas between the mature bone and the titanium, and the interposed amorphous zone was still observed. Occasionally, a 200-nm-thick layer, thought to be cell remnant, was seen. As calculated in an image-processing, system analysis, the percent bone contact and the thickness and area of the surrounding bone for the Ti implant at day 28 were 43.6%, 30.4 microns, and 0.10 mm2, respectively, and those at day 730 were 89.9%, 53.5 microns, and 0.19 mm2, respectively. In summary, although the passage of time may affect bone maturity, interfacial cells remain at the bone-Ti interface as a uniform layer together with unmineralized bone.

Animals↗

A mechanical evaluation of TiO2-gritblasted and Ca-P magnetron sputter coated implants placed into the trabecular bone of the goat: Part 1.

The influence of Ca-P magnetron sputter coated implants on the mechanical anchorage was evaluated in a goat model. Therefore, uncoated and coated screw designed commercially pure titanium TiO2-blasted implants were inserted into the trabecular bone of the femoral condyles of 12 goats. The thicknesses of the coatings were 0.1 micron (CaP-0.1), 1.0 micron (CaP-1) and 4.0 microns (CaP-4). In addition, uncoated TiO2-blasted implants (Ti) were used as control. Evaluation of the interface strength and appearance, using torque test and scanning electron microscopy, was done at implantation periods of 6 and 12 weeks. Although, especially at 6 weeks of implantation, the Ca-P coated implants showed higher failure torque values than the TiO2 blasted implants, the observed differences for type of implant and evaluation period were not significant (P > 0.1). SEM evaluation showed that all implants with failure values of more than 100 N conducted bone growth into their screw threads. In addition, we observed that the fracture plane for the CaP-4 implants was situated at the coating-implant interface or inside the coating. For the CaP-1 and CaP-0.1 the fracture line could not be determined definitely. For the Ti implants, the fracture torque testing resulted in failure at the bone-implant interface. Therefore, we conclude that all implants resulted in a good bonding strength with the surrounding bone. The sputtered Ca-P coatings seemed to improve the initial fixation of the TiO2 blasted implants.

Animals↗

A histological and histomorphometrical investigation of fluorapatite, magnesiumwhitlockite, and hydroxylapatite plasma-sprayed coatings in goats.

Plasma-sprayed ceramic coatings of fluorapatite (FA), magnesiumwhitlockite (MW), and hydroxylapatite (HA), and noncoated Ti-6Al-4V alloy (Ti) implants were evaluated histologically and histomorphometrically in a goat animal study. Cylindrical Ti-6Al-4V plugs were plasma-spray-coated with FA, MW, and HA. Noncoated, grit-blasted Ti plugs served as controls. The plugs were implanted into the right femur and left humerus of 20 adult goats. The results were evaluated using descriptive histology and histomorphometry. The histomorphometry consisted of measurements of bone apposition and coating thickness. The results demonstrated that FA showed a high amount of bone apposition without signs of degradation or dissolution. MW showed considerable reduction in thickness and at 12 weeks an adverse tissue reaction. However, at 25 weeks the amount of bone apposition was significantly increased compared with the 12-week implants. HA revealed considerable and progressive reduction in thickness and at 25 weeks a lower amount of bone apposition than FA and MW. At 12 weeks the Ti implants did reveal bone apposition, although frequently localized fibrous tissue was visible. At 25 weeks the Ti implants did not differ in bone apposition from the HA implants. Further studies are necessary on the effect of degradation or dissolution of HA on the compatibility with bone.

Alloys↗

A mechanical investigation of fluorapatite, magnesiumwhitlockite, and hydroxylapatite plasma-sprayed coatings in goats.

Ceramic coatings of fluorapatite (FA), magnesiumwhitlockite (MW), and hydroxylapatite (HA), and noncoated Ti-6Al-4V alloy (Ti) implants were evaluated before and after implantation in an animal study. Cylindrical plugs were coated by plasma-spraying with FA, MW, and HA. X-ray-diffraction patterns showed for FA and HA a crystalline and for MW an amorphous-crystalline coating structure. The plugs were implanted into the right femora and left humeri of 16 adult goats. Follow-up periods were 12 and 25 weeks. The in vivo results were evaluated using push-out tests and scanning electron microscopy. There were significant differences in push-out strengths between femur and humerus. The FA and HA implants showed significantly higher push-out strengths than the MW and Ti alloy implants, especially for the 12 week follow-up period. Furthermore, at 12 weeks, MW showed significantly lower push-out strengths than Ti alloy. SEM-investigation of the interfaces revealed that FA did not degrade while both MW and HA showed extensive degradation at 12 and 25 weeks. In addition, the interface after push-out testing showed for the MW, HA, and Ti alloy implants to be fractured at the implant-tissue interface and for the FA to be fractured at the coating-titanium interface.

Animals↗

A comparison of hydroxyapatite (HA) -coated threaded, HA-coated cylindric, and titanium threaded endosseous dental implants.

PURPOSE: The purpose of this study was to compare the success of hydroxyapatite (HA) -coated and machined titanium (Ti) implants in a 5-year randomized, controlled clinical trial conducted at 2 centers. MATERIALS AND METHODS: Each of 120 edentulous patients received HA-coated threaded, HA-coated cylindric, and machined Ti threaded implants in a randomized design using 5 or 6 implants. Digital radiographs allowed for yearly measurements of bone loss. Calibrated clinicians also measured mobility, Gingival Index, Plaque Index, probing depth, and recession. A Kaplan-Meier analysis was used to compare the proportion of ailing implants (defined as less than 2 mm of alveolar bone loss over 5 years) for each type of implant design. The criteria employed to assess implant outcome included the need for successful implants to lose less than 2 mm of bone support over the 5 years following placement of the prosthesis. RESULTS: This analysis revealed that 95.2% of machined Ti threaded implants and 97.92% of HA-coated threaded implants were successful, while 99.0% of HA-coated cylindric implants experienced less than 2 mm of bone loss (P < .06). DISCUSSION: All types of implants placed in this study had success rates above 95%. CONCLUSION: Over 5 years, the success rate tended to favor HA-coated implants.

Adolescent↗

Electrochemical impedance spectroscopy characterization of passive film formed on implant Ti-6Al-7Nb alloy in Hank's solution.

The influence of potential on electrochemical behavior of Ti-6Al-7Nb alloy under simulated physiological conditions was investigated by electrochemical impedance spectroscopy (EIS). The experimental results were compared with those obtained by potentiodynamic polarization curves. All measurements were carried out in Hank's aerated solution at 25 degrees C, at pH 7.8 and at different potentials (corrosion potential, 0 mV(SCE), 1000 mV(SCE), and 2000 mV(SCE)). The EIS spectra exhibited a two-step or a two-time constant system, suggesting the formation of a two-layer oxide film on the metal surface. The high corrosion resistance, displayed by this alloy in electrochemical polarization tests, is due to the dense inner layer, while its osseointegration ability can be ascribed to the presence of the outer porous layer.

Alloys↗

Bioactive glass coatings with hydroxyapatite and Bioglass particles on Ti-based implants. 1. Processing.

Silicate-based glasses with thermal expansion coefficients that match those of Ti6A14V were prepared and used to coat Ti6A14V by a simple enameling technique. Bioglass (BG) or hydroxyapatite (HA) particles were embedded on the coatings in order to enhance their bioactivity. HA particles were immersed partially during heating and remained firmly embedded on the coating after cooling. There was no apparent reaction at the glass/HA interface at the temperatures used in this work (800-840 degrees C). In contrast, BG particles softened and some infiltration into the glass coating took place during heat treatment. In this case, particles with sizes over 45 microm were required, otherwise the particles became hollow due to the infiltration and crystallization of the glass surface. The concentration of the particles on the coating was limited to 20% of surface coverage. Concentrations above this value resulted in cracked coatings due to excessive induced stress. Cracks did not propagate along the interfaces when coatings were subjected to Vickers indentation tests, indicating that the particle/glass and glass/metal interfaces exhibited strong bonds. Enameling, producing excellent glass/metal adhesion with well-attached bioactive particles on the surface, is a promising method of forming reliable and lasting implants which can endure substantial chemical and mechanical stresses.

Alloys↗

Room-temperature continuous-wave operation of Ti:sapphire buried channel-waveguide lasers fabricated via proton implantation.

Fabrication and laser operation of proton-implanted Ti:sapphire buried channel waveguides is reported for the first time to our knowledge. Without any postimplantation annealing of the structures, continuous laser operation near 780 nm was demonstrated at room temperature at an absorbed pump power threshold of 230 mW. Single-transverse-mode laser emission was observed with measured beam propagation factors M(2)(x) and M(2)(y) of 1.5 and 1.2, respectively. An output power of 12.4 mW for 1 W pump power was obtained with an output coupler of 4.6% transmission at the signal wavelength. Higher output powers were measured in waveguides with larger cross sections exhibiting multimode laser emission.

Journal Article↗

In vivo comparison of the osseointegration of vacuum plasma sprayed titanium- and hydroxyapatite-coated implants.

For the last 15 years, orthopedic implants have been coated with hydroxyapatite (HA) to improve implant fixation. The osteoconductive effect of HA coatings has been demonstrated in experimental and clinical studies. However, there are ongoing developments to improve the quality of HA coatings. The objective of this study was to investigate whether a rough and highly crystalline HA coating applied by vacuum plasma spraying (VPS) had a positive effect on the osseointegration of special, high-grade titanium (Ti) implants with the same surface roughness. Ti alloy implants were coated (VPS) with special, high-grade Ti or HA. The osseointegration of the implants was evaluated by either light microscopy or pullout tests after 1, 2, and 4 weeks of unloaded implantation in the cancellous bone of 18 sheep. The interface shear strength increased significantly over all time intervals. By 4 weeks, values had reached approximately 10N/mm(2). However, the difference between the coatings was not significant at any time interval. Direct bone-implant contact was significantly different between the coatings after 2 and 4 weeks, and reached 46% for Ti and 68% for HA implants by 4 weeks. This study indicates that the use of a rough and highly crystalline HA coating, applied by VPS, enhances early osseointegration. Accelerated establishment of secondary implant fixation decreases the risk of early loosening.

Animals↗

Electrochemical properties of suprastructures galvanically coupled to a titanium implant.

In recent years, dental implants have been widely used for the aesthetic and functional restoration of edentulous patients. Dental implants and restorative alloys are required with high corrosion resistance. Suprastructures and implants of different compositions in electrical contact may develop galvanic or coupled corrosion problems. In addition to galvanic corrosion, crevice and pitting corrosion may occur in the marginal gap between dental implant assemblies. In this study, gold, silver-palladium, cobalt-chromium, and nickel-chromium suprastructures were used to investigate their galvanic and crevice corrosion characteristics in combination with titanium (Ti) implants. Potentiodynamic and potentiostatic testing were performed in artificial saliva at 37 degrees C. Potentiodynamic testing was carried out at the potential scan rate of 1 mV/s in the range of -600-1600 mV (SCE). Potentiostatic testing was performed with an open-circuit potential and current densities at -250, 0, and 250 mV (SCE) in artificial saliva. After electrochemical testing, surface morphologies and cross-sections were examined using micrographs of the samples. Potentiodynamic test results indicated that suprastructure/Ti implant couples produced passive current densities in the range of 0.5-12 microA/cm(2); Ti abutment/Ti implant and gold/Ti implant couples exhibited relatively low passive current densities; Co-Cr/Ti implant couples the highest. Co-Cr and Ni-Cr/Ti implant couples showed breakdown potentials of 700 and 570 mV (SCE), respectively. The open-circuit potentials of silver, Ti abutment, gold, Ni-Cr, and Co-Cr/Ti implant couples were -93.2 +/- 93.9, -123.7 +/- 58.8, -140.0 +/- 80.6, -223.5 +/- 35.1, and -312.7 +/- 29.8 mV (SCE), respectively, and did not change with immersion time. The couples exhibited cathodic current densities at -250 mV (SCE); in particular, gold and silver alloys showed high cathodic current densities of -3.18 and -6.63 microA/cm(2), respectively. At 250 mV (SCE), Ti abutment/Ti implant couples exhibited a minimum current density of 9.48 x 10(-2) microA/cm(2), but gold, Ni-Cr, Co-Cr, and silver/Ti implant couples exhibited 0.313, 1.27, 5.60, and 8.06 microA/cm(2), respectively. All couples exhibited relatively low current densities at 0 mV (SCE). Photomicrographs after electrochemical testing showed crevice or pitting corrosion in the marginal gap and at the suprastructure surface. Although of the tested samples Co-Cr/Ti implant couples showed the possibility of galvanic corrosion, its degree was not significant. However, it should be borne in mind that galvanic corrosion can accelerate localized corrosion, such as crevice or pitting corrosion.

Alloys↗

Direct replacement of failed CP titanium implants with larger-diameter, HA-coated Ti-6Al-4V implants: report of five cases.

Failure to osseointegrate traditionally mandates immediate implant removal, followed by a 1-year healing period before placing a second implant into the same area. This report presents five cases in which failed screw-type, commercially pure titanium implants were immediately replaced by ledge-type, hydroxyapatite-coated, Ti-6Al-4V implants in the same sockets. These cases suggest that the 1-year healing period may not be necessary, provided that (1) the socket can be reprepared to eliminate thread grooves and invasive soft tissue, (2) the replacement implant is larger in diameter than the original implant, and (3) sufficient available bone remains for the procedures.

Adult↗

The effect of three different calcium phosphate implant coatings on bone deposition and coating resorption: a long-term histological study in sheep.

The present study investigated the hypothesis that hydroxyapatite (HA), tricalcium phosphate (TCP), and a HA-gel coated on endosseous titanium (Ti) implants by spark discharging (SD) and dip coating would achieve predictable osseointegration without evident bioresorption of the coatings on the long term. A costal sheep model was used for the implantation of the HA/SD, HA/TCP/SD, and HA-gel/SD specimens, which were retrieved 6 and 12 months following implantation. HA and Ti coatings on implants obtained by conventional plasma spraying (HA/PS, Ti/PS) were used as controls. Microscopy showed that osseointegration was achieved from all types of implants. No evidence for bioresorption of the HA/SD, HA/TCP/SD, and HA-gel/SD coatings was present but cohesive failure with disruption of the coating/implant interface was seen. A statistical analysis of the histomorphometrical data showed no time-dependent effect, however. HA/PS coatings achieved significantly higher bone-implant contact (BIC) percentages of the total implant surface (toBIC) than the other types of coatings (P=0.01). If the BIC percentages were traced separately for implant portions placed into cortical and cancellous bone (coBIC and caBIC, respectively), detailed analysis showed that the caBIC values of HA-gel/SD and HA/PS coatings were significantly higher than that of the other types of coatings (P=0.01). CaBIC values were highly correlated with toBIC values (P<0.001). The present study showed that the preparation techniques used produced thin, dense, and unresorbable coatings that achieved osseointegration. Compared with the control coatings, however, only HA-gel/SD coating can be recommended from the investigated preparation techniques for a future clinical use if a better coating cohesion is achieved.

Animals↗

Evaluation of a predictive model for implant surface topography effects on early osseointegration in the rat tibia model.

STATEMENT OF PROBLEM: Alterations in commercially pure titanium (cp Ti) implant surface topography can be made to increase bone formation or the interfacial shear strength of bone at the functioning implant. It is not known whether these 2 goals are congruent or mutually exclusive. PURPOSE: The aim of this study was to determine the effect of implant surface topography parameters of calculated biomechanical significance on the process of bone formation in a rat tibia model of osseointegration. MATERIAL AND METHODS: Implants (cp Ti grade IV) were machined and subsequently treated by grit blasting or grit blasting and 6.4 mol/L HCl. Measurements of surface roughness were made by atomic force microscopic analysis of similarly treated titanium disks. Cleaned and sterilized implants (12 machined, 12 with nonideal pit morphology, 12 with ideal pit morphology) were placed into the tibiae of 400-g male Wistar rats by using a series of drills, irrigation, and a self-tapping procedure. After 3 weeks, tibiae were harvested and processed and embedded in methyl methacrylate resin. Polished sections were examined by backscatter electron microscopy, and the percentage implant surface contacting bone was measured with the Scionics PC image analysis program. RESULTS. The implants possessing a proposed ideal pit morphology supported significantly greater bone formation at the implant surface (54% +/- 7% bone-to-implant contact [P<.003]) than the nonideal pit morphology (40% +/- 15%) or machined surfaces (34% +/- 6%). CONCLUSION: Implant surfaces with a proposed ideal pit morphology (which possess a calculated biomechanical significance) enhanced bone formation at early periods after placement in the rat tibia model.

Animals↗