Abstract
The evolution of bone tissue quantity and quality in contact with the surface of orthopedic and dental implants is a strong determinant of the surgical outcome but remains difficult to be assessed quantitatively. The aim of this study was to investigate the performance of a quantitative ultrasound (QUS) method to measure bone-implant interface (BII) properties. A dedicated animal model considering coin-shaped titanium implants with two levels of surface roughness (smooth, Sa = 0.49 µm and rough, Sa = 3.5 µm) allowed to work with a reproducible geometry and a planar interface. The implants were inserted in rabbit femurs and tibiae for 7 or 13 weeks. The ultrasonic response of the BII was measured ex vivo, leading to the determination of the 2-D spatial variations of bone in contact with the implant surface. Histological analysis was carried out to determine the bone-implant contact (BIC) ratio. The amplitude of the echo was significantly higher after 7 weeks of healing time compared to 13 weeks, for both smooth (p < 0.01) and rough (p < 0.05) implants. A negative correlation (R = − 0.63) was obtained between the ultrasonic response and the BIC. This QUS technique is more sensitive to changes of BII morphology compared to histological analyses.
Highlights
The evolution of bone tissue quantity and quality in contact with the surface of orthopedic and dental implants is a strong determinant of the surgical outcome but remains difficult to be assessed quantitatively
During the healing period lasting between a few weeks up to a few months—depending on the animal model, the implantation site and the implant’s geometry and surface r oughness6,7—new bone is formed and remodeled leading to an osseointegrated bone-implant interface (BII)[8]
Except for Sal, which corresponds to a distance in the plane of the surface, all other roughness parameters (Sz, Sda, Sdv) are higher for the surface corresponding to implants from the R series compared to the S series
Summary
The evolution of bone tissue quantity and quality in contact with the surface of orthopedic and dental implants is a strong determinant of the surgical outcome but remains difficult to be assessed quantitatively. Several empirical methods are used by dental and orthopaedic surgeons in order to assess primary and secondary implant stability in vivo, such as percussion tests based on the sound produced by an implant impacted by a metallic rod. Such approaches are not reliable and depend on the surgeon proprioception.
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