Abstract
Simple SummaryThe bone, as a vertebrate support tissue, is capable of adapting its structure and function to the mechanical demands resulting from the loads that are produced during the performance of its activity. This regulatory action also occurs during the healing processes of a fracture. The purpose of this study was to determine to what extent a dynamic load was capable of modulating the bone healing response around a titanium implant. The study was carried out on experimental rabbits, to which dental implants were placed in the tibiae and there were two test groups, one in which they did not undergo exercise during healing period and another that ran daily during this process on a treadmill. The trail results showed an improvement in the osseointegration process of the implant in the group in which it was subjected to load. The importance of these results is that it opens the door to a better understanding of the mechanisms that can modulate bone healing, especially around dental implants, supporting implant loading protocols that are based on efficiency.Objectives: To determine the effect of mechanical loading of bone on the stability and histomorphometric variables of the osseointegration of dental implants using an experimental test in an animal model. Materials and Methods: A total of 4 human implants were placed in both tibiae of 10 New Zealand rabbits (n = 40). A 6-week osseointegration was considered, and the rabbits were randomly assigned to two groups: Group A (Test group) included 5 rabbits that ran on a treadmill for 20 min daily during the osseointegration period; Group B (Controls) included the other 5 that were housed conventionally. The monitored variables were related to the primary and secondary stability of the dental implants (implant stability quotient—ISQ), vertical bone growth, bone to implant contact (BIC), area of regenerated bone and the percentage of immature matrix. Results: The results of the study show a greater vertical bone growth (Group A 1.26 ± 0.48 mm, Group B 0.32 ± 0.47 mm, p < 0.001), higher ISQ values (Group A 11.25 ± 6.10 ISQ, 15.73%; Group B 5.80 ± 5.97 ISQ, 7.99%, p = 0.006) and a higher BIC (Group A 19.37%, Group B 23.60%, p = 0.0058) for implants in the test group, with statistically significant differences. A higher percentage of immature bone matrix was observed for implants in the control group (20.68 ± 9.53) than those in the test group (15.38 ± 8.84) (p = 0.108). A larger area of regenerated bone was also observed for the test implants (Group A 280.50 ± 125.40 mm2, Group B 228.00 ± 141.40 mm2), but it was not statistically significant (p = 0.121). Conclusions: The mechanical loading of bone improves the stability and the histomorphometric variables of the osseointegration of dental implants.
Highlights
The osseointegration of dental implants has often been described as a model of primary or direct healing of a bone fracture
Several theoretical studies related to traumatology report that dynamic loading during the bone healing process can increase the levels of mesenchymal stem cells (MSC) in the endosteum, chondrogenic growth factors in the periosteum and cortical areas around the callus of the fracture [4]
The experiment focused on a rabbit tibia study that involved implant placement to compare the arrangement and characteristics of peri-implant bone tissue formed during osseointegration in animals that had and had not received biomechanical stimuli
Summary
The osseointegration of dental implants has often been described as a model of primary or direct healing of a bone fracture. Mechanical stability refers to the fact that an excessive force at the fracture edges or between the osteoid apposition line and the titanium surface during osseointegration of a dental implant can lead to successive ruptures of the newformed capillaries and impair the repair process mediated by fibrous tissue [2]. A study recently published by the same research group that conducted this study showed that the use of integrated dental implants and those that were immediately loaded after surgical placement through masticatory loading increased their stability [3]. These results suggest that positive functional results can be expected during the integration of implants. Several theoretical studies related to traumatology report that dynamic loading during the bone healing process can increase the levels of mesenchymal stem cells (MSC) in the endosteum, chondrogenic growth factors in the periosteum and cortical areas around the callus of the fracture [4]
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