Abstract
Osseointegration is likely the result of an immunologically driven bone reaction to materials such as titanium. Osseointegration has resulted in the clinical possibility to anchor oral implants in jaw bone tissue. However, the mechanisms behind bony anchorage are not fully understood and complications over a longer period of time have been reported. The current study aims at exploring possible differences between copper (Cu) and polyetheretherketone (PEEK) materials that do not osseointegrate, with osseointegrating cp titanium as control. The implants were placed in rabbit tibia and selected immune markers were evaluated at 10 and 28 days of follow-up. Cu and PEEK demonstrated at both time points a higher immune activation than cp titanium. Cu demonstrated distance osteogenesis due to a maintained proinflammatory environment over time, and PEEK failed to osseointegrate due to an immunologically defined preferential adipose tissue formation on its surface. The here presented results suggest the description of two different mechanisms for failed osseointegration, both of which are correlated to the immune system.
Highlights
Osseointegration [1] is a central event for oral implant function
The gene expression analysis results at 10 days, comparing Cu and PEEK against that osseointegrates (Ti), are displayed in the volcano plots (Figures 2 and 3) and data given in corresponding tables (Tables 3 and 4) with the numerical results expressed in fold-change and significance (p value, y-axis)
At 10 and 28 days after implantation in rabbit tibia, both Cu and PEEK show a higher immune activation than Ti. This more pronounced and extended immune reaction translates into a prolonged inflammatory phase of the healing period, and may be the cause for the bone tissue failing to form a layer in direct contact with these materials, as shown in the histological sections
Summary
Osseointegration [1] is a central event for oral implant function. This specific bone reaction has been described and studied at length for titanium and other materials. Technical innovations have led to improvements of bone reactions, such as material surface topographical changes [2,3,4] that have been vastly adopted by the oral implant industry, as well as different forms of chemical surface modulations [5,6]. Such surface related innovations have resulted in improved clinical results and widening of clinical indications [7,8]. Osseoaintdeogmraintiaonnt isMt2hums saecreonphaasgteheprheesnuolttyopfean[1F5B],R iwn hiccohntirnastthetolonogthreurn mmaateyriaaclshiesvuecha faosreign bodypsehoqoluyrteilttihebrermrieutomhfefraokllellootowwn-eiun(pgP.EfOoEsrKsle)ooaninngdtetgCerroamptipolenorai(sdCtiuhn)ugtshosafetiempnrpaesslaetnnhtetsmr[ei1sxu6e]ldt. oHMf o1a/wnMFe2BvpRerh,wetnhhoiectyhbpaienssitshatfeotlhroenthgsearmuconentrol of bonmeamy aecthaibeovleisamfoareroigunnbdoidmy peqlauniltisbriinumheaallltohwainngdfdorisleoansgetreermmaloinasdilnagrgoeflyimupnlacnletsar[1[61]7. ]H. oPwaretviecru, larly the evthene tbsatsaiskfinorgtphelaccoenatrfotel rofthbeonineflmaemtamboaltiosmryaproeruinoddiomfpilnaintitaslinhehaelailnthg aanndddaispeoassesirbelme aiminms luarngoelloygical reguluatnicolneaor f[1b7o].nPearmticeutalabrolylitshme eavreenetsxtaamkipnlgepsloacfeimaftpeor rtthaenitnffilaemldms aftoorryfupretrhioedr sotfuindiiteiasl. hOeaulringgraonudp has demoanpsotrsasitbelde itmhamtutnitoalnogiuicmal raecgtuivlaattieosn tohfeboimnemmuentaebosylismtemarewexhaemnpcloesmopf aimrepdorttoanat sfiheladms fsoirtfeuartth1e0r and 28 dasytus doifesf.oOlluorwg-ruopup[1h2a]s. dIenmPoanrstrIatoefdtthhiast stietarineisumofasctuivdaites t(hwehimermeutnheescyustrermenwt hweonrckomispPaarerdt ItIo), the imporatashnacme osfittehaets1p0eacnifidc2i8mdmayusnoef rfeosllpoown-suepa[r1o2u].nInd PdaiffrteIreonf tthmisasteerriieaslsofwshtuedniecso(mwphaerreedthteocausrrheanmt site was dwemoroknisstrPaatretdIIa),t tahne eimarplyorsttaangcee ooff 1th0edsapyesci[f1ic5]i.mTmhuenceurrreespnot nstsuedayroauinmdsdaitffceoremnpt amriantegrimalastwerhiaelns that danodnPocaptEotroEmocsKnospomea(uocrpnieonadcnrteiestdnoigdgFraeBamrstRehead,aitniem.aresio.sab,iflitttsoeetistiwnshtseaamurtsetaddsmtoee[1mran8itao]oe)lntrsaisoanctrslodas[petP1eopE9die]En)ratK,te(tkga(ocrnnoaaoetnewmas,rindlaiy.teeter.so,retaiditaneglasdettbuohmifcaoe1atin0taoeedsrrpistaaremyolossnai[ncot1eotu5repi]ngap. clrTeea[rh1dte9e(kF]sc)n,Bu, octRropwreiantnnimttstasooanttfuieitnudrtdimyiasulasct(uihecmeoaasstn[t1r8o]l)) at 10 oasnsdeo2in8tdegaryaste, si,ncoprdtitearntiouminv(ceosnttirgoal)teaat n1d0 acnodm2p8ardeayths,eirnesoprdeecrtitvoeiinmvemstuignaetemaondducloamtipoanreretahcetions betwereesnptehcteivine flimammumnaetmoroyd(u1l0atdioanyrse)aactniodnps obsettiwnefleanmthme aintoflraym(m28atdorayy(s1)0sdtaagyes)saonfdbpoonsetinhfelaamlinmga.tory (28 days) stages of bone healing
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