Comparison of contact radiographed and stained histological sections for osseointegration analysis of dental implants: an in vivo study

Abstract

Histology is still regarded as the gold-standard to determine bone implant contact (BIC) as a parameter representing implant stability. As the further processing of cut slices for contact radiography (CR) to stained and polished histological sections is time consuming and error prone, our aim was to assess agreement between CR and Giemsa-eosin (GE) stained sections with regard to dental implants. Threaded dental titanium implants (n=54) from the maxillae of Goettingen minipigs were evaluated. After 28 and 56days, BIC and the ratio of bone volume to total volume (BV/TV; 1000μm) were determined on the same sections by using CR and GE staining, and the results were compared. Moderate differences for BIC (0.6%; P=.53) and BV/TV (1.3%; P=.01) between the methods were determined, in which CR overestimated BIC and BV/TV. A strong correlation was seen between the modalities concerning BIC (28days: r=0.84; 56days: r=0.85; total: r=0.85) and BV/TV (r=0.96; r=0.94; r=0.96; all: P<.0001). CR enabled determination of the bone-to-implant interface in comparison with GE-stained sections. BIC and BV/TV were slightly overestimated but correlated strongly between the methods. Therefore, if BIC and BV/TV are sufficient endpoints, CR is adequate and no further preparation and staining are necessary.