Percentage Of Bone-implant Contact Research Articles

Peri-implant Bone Response Around a Human Hydroxyapatite-Coated Implant Retrieved After a 10-Year Loading Period: A Case Report

This case report presents a histologic and histomorphometric evaluation of the peri-implant tissues of a HA-coated implant retrieved due to peri-implantitis after a 10-year loading period. The implant was retrieved with a trephine and treated to obtain thin ground sections. At low-power magnification mostly compact, mature bone with small marrow spaces could be observed at the interface with the implant. The coating was always present in the areas where bone was detected, the bone was always in close contact with the coating, and there was no detachment between the metal and coating or between the coating and bone. Areas of bone remodeling were demonstrated by the presence of many secondary osteons and reversal lines close to the implant surface. The bone-implant contact percentage was 36.3% ± 1.2%. The percentage of the implant surface covered by the HA coating without bone, where bone may have detached during retrieval, was 32.6% ± 2.8%. This HA-coated implant, continued to demonstrate more than adequate BIC after many years of function and the potential to maintain osseointegration in the long term.

Comparative Analysis between Zirconia Implant and Titanium Implant

Various ceramic implant systems made of yttria-stabilized tetragonal zirconia polycystal (Y-TZP) have become commercially available in recent years. A search of the literature was performed to assess the clinical success of dental Y-TZP implants and whether the osseointegration of Y-TZP is comparable to that of titanium, the standard implant material. No controlled clinical studies in humans regarding clinical outcomes or osseointegration could be identified. Clinical data were restricted to case studies and case series. Only 7 animal studies were found. Osseointegration was evaluated at 4 weeks to 24 months after placement in different animal models, sites and under different loading conditions. The mean bone-implant contact percentage was above 60% in almost all experimental groups. In studies that used titanium implants as a control, Y-TZP implants were comparable to or even better than titanium implants. Surface modifi cations may further improve initial bone healing and resistance to removal torque. Y-TZP implants may have the potential to become an alternative to titanium implants but cannot currently be recommended for routine clinical use, as no long-term clinical data are available.

Relation between initial implant stability quotient and bone-implant contact percentage: an in vitro model study

This study evaluated the correlation between the initial stability of a dental implant, quantified as the implant stability quotient (ISQ), and the bone-implant contact percentage ( BIC%). Dental implants were inserted into specimens comprising an artificial cortical shell representing cortical bone and foam bone representing cancellous bone with 4 elastic moduli. Each specimen with an implant was subjected to microcomputed tomography (micro-CT) scanning, from which the 2D and 3D BIC% values were calculated. The values of the Spearman correlation coefficient (r) were calculated between the ISQ and the 2D and 3D BIC% values. Increasing the elasticity of the specimen enhanced the ISQ. There was statistically significant correlation between the ISQ and 3D BIC% values (r = 0.85, P < .0001). However, the correlation between ISQ and 2D BIC% values was not statistically significance (r = 0.42, P = .062). The initial implant stability was strongly positively correlated with the 3D BIC%.

Effect of osteoblast cell culture on the bone implant contact

Purpose. The aim of this study is to acquire an ideal bone implant contact under the cover of osteogenic effect of osteoblasts derived from Mesenchymal Stem Cells (MSCs). Materials and methods. Thirty dental implants were used for this study. Implants were placed in sheep mandibles and defects were created 4 mm coronally in the dental implants. These defects were filled with Platelet Rich Plasma (PRP) in one group and with PRP + Osteoblast Cell Culture (OCC) in another group. No procedure was conducted on the control group defects (empty defect group). Eight weeks later, osseointegration was investigated with Bone Implant Contact (BIC) measurements histomorphologically. Data were checked statistically. Results. The variation of BIC rates between Empty Defect Group and PRP groups was significant (p <0.05). The BIC rate of the PRP group was higher than that of the Empty Defect Group. The variation of BIC rates between Empty Defect Group and PRP + OCC groups was significant (p <0.05). The BIC rate of the PRP + OCC group was higher than that of the Empty Defect Group. The variation of BIC rates between PRP and PRP + MSC groups was significant (p<0.05). The BIC rate of the PRP + OCC group was higher than that of the PRP group. At the end of the 8-week healing period, it was observed that the percentage of BIC was highest in the PRP + OCC group. Conclusions. Implant–bone connection was better in the OCC−PRP group compared with the PRP group and the empty defect group. The use of OCC-PRP combination was effective on healing. The BIC value was increased significantly by OCC.

Primary stability and histomorphometric bone-implant contact of self-drilling and self-tapping orthodontic microimplants

The aim of this study was to evaluate the primary stability and the histomorphometric measurements of self-drilling and self-tapping orthodontic microimplants and the correlations between factors related to host, implant, and measuring technique. Seventy-two self-drilling and self-tapping implants were placed into bovine iliac crest blocks after computed tomography assessments. Insertion torque values, subjective assessments of stability, and Periotest (Medizintecknik Gulden, Modautal, Germany) measurements were performed for each implant. Twelve specimens of each group were assigned to histologic and histomorphometric assessments. The differences between insertion torque values, most Periotest values, and subjective assessments of stability scores were insignificant (P >0.05). The bone-implant contact percentage of the self-drilling group (87.60%) was higher than that of the self-tapping group (80.73%) (P <0.05). Positive correlations were found between insertion torque value, cortical bone thickness, and density in both groups (P <0.05). Negative correlations between insertion torque values and Periotest values were mostly observed in the self-drilling group (P <0.05). Positive correlations were found between bone-implant contact percentages, cortical bone densities, and insertion torque values in both groups (P <0.05). The differences between insertion torque values and corresponding subjective assessments of stability scores were different in both groups (P <0.05). The differences in insertion torque values, Periotest values, and subjective assessments of stability scores of self-drilling and self-tapping implants were insignificant. Self-drilling implants had higher bone-implant contact percentages than did self-tapping implants. Significant correlations were found between parameters influencing the primary stability of the implants.

Osseointegration of two different phosphate ion‐containing titanium oxide surfaces in rabbit cancellous bone

This study assessed the osseointegration of grit-blasted titanium (Ti) implants with a hydrophilic phosphate ion-incorporated oxide surface in rabbit cancellous bone, and compared its bone healing with commercially available phosphate-incorporated clinical implants obtained by micro-arc oxidation (TiUnite, TU implant). The hydrophilic phosphate-incorporated Ti surface (P implant) was produced by hydrothermal treatment on grit-blasted moderately rough-surfaced clinical implant. The TU surface was used as a control. The surface characteristics were evaluated by field emission-scanning electron microscopy, X-ray photoelectron spectroscopy, optical profilometry, and inductively coupled plasma-atomic emission spectroscopy (ICP-AES). Thirty-two threaded implants with lengths of 10 and 3.3 mm diameter (16 P implants and 16 TU implants) were placed in the femoral condyles of 16 New Zealand White rabbits. Histomorphometric analysis, removal torque tests, and surface analysis of the torque-tested implants were performed 4 weeks after implantation. The P and TU implants displayed micro-rough surface features with similar Ra values at the micron-scale. ICP-AES analysis revealed that both the P and TU implants released phosphate ions into the solution. The torque-tested P and TU implants exhibited a considerable quantity of bone attached to the surface. The P implants exhibited significantly higher bone-implant contact percentages, both in terms of the all threads region and the total lateral length of implants compared with the TU implants (P < 0.01), but no statistical difference was found for the removal torque values. These results suggest that the phosphate-incorporated Ti oxide surface obtained by hydrothermal treatment achieves rapid osseointegration in cancellous bone by increasing the degree of bone-implant contact.

Relation between insertion torque and bone–implant contact percentage: an artificial bone study

The purpose of this study was to determine the correlation between the peak insertion torque value (ITV) of a dental implant and the bone-implant contact percentage (BIC%). Dental implants were inserted into specimens comprising a 2-mm-thick artificial cortical shell representing cortical bone and artificial foam bone representing cancellous bone with four densities (groups 1 to 4--0.32, 0.20, 0.16, and 0.12 g/cm(3)). Each specimen with an inserted implant was subjected to micro-computed tomography (micro-CT) scanning, from which the 3D BIC% values were calculated. Pearson's correlation coefficients (r) between the ITV and BIC% were calculated. The ITVs in groups 1 to 4 were 56.2 ± 4.6 (mean±standard deviation), 45.6 ± 0.9, 43.3 ± 4.3, and 38.5 ± 3.4 N cm, respectively, and the corresponding BIC% values were 41.5 ± 0.5%, 39.0 ± 1.0%, 30.8 ± 1.1%, and 26.2 ± 1.6%. Pearson's correlation coefficient between the ITV and BIC% was r = 0.797 (P < 0.0001). The initial implant stability, quantified as the ITV, was strongly positively correlated with the 3D BIC% obtained from micro-CT images. The ITV of a dental implant can be used to predict the initial BIC%; this information may provide the clinician with important information on the optimal loading time.

Bone integration capability of nanopolymorphic crystalline hydroxyapatite coated on titanium implants

The mechanism by which hydroxyapatite (HA)-coated titanium promotes bone–implant integration is largely unknown. Furthermore, refining the fabrication of nano-structured HA to the level applicable to the mass production process for titanium implants is challenging. This study reports successful creation of nanopolymorphic crystalline HA on microroughened titanium surfaces using a combination of flame spray and low-temperature calcination and tests its biological capability to enhance bone–implant integration. Sandblasted microroughened titanium implants and sandblasted + HA-coated titanium implants were subjected to biomechanical and histomorphometric analyses in a rat model. The HA was 55% crystallized and consisted of nanoscale needle-like architectures developed in various diameters, lengths, and orientations, which resulted in a 70% increase in surface area compared to noncoated microroughened surfaces. The HA was free from impurity contaminants, with a calcium/phosphorus ratio of 1.66 being equivalent to that of stoichiometric HA. As compared to microroughened implants, HA-coated implants increased the strength of bone–implant integration consistently at both early and late stages of healing. HA-coated implants showed an increased percentage of bone–implant contact and bone volume within 50 μm proximity of the implant surface, as well as a remarkably reduced percentage of soft tissue intervention between bone and the implant surface. In contrast, bone volume outside the 50 μm border was lower around HA-coated implants. Thus, this study demonstrated that the addition of pure nanopolymorphic crystalline HA to microroughened titanium not only accelerates but also enhances the level of bone–implant integration and identified the specific tissue morphogenesis parameters modulated by HA coating. In particular, the nanocrystalline HA was proven to be drastic in increasing osteoconductivity and inhibiting soft tissue infiltration, but the effect was limited to the immediate microenvironment surrounding the implant.

Histology of a dental implant with a platform switched implant-abutment connection

Background Peri-implant crestal bone must be stable for aesthetic reasons. Aim of this study was a histologic analysis of an implant with a platform switched implant-abutment connection. A 32-year-old male patient participated in this study. The patient needed a bilateral mandibular restoration. Four implants were used, and were immediately restored and loaded the same day of insertion. After a 6 weeks healing period, one implant with platform-switched abutment was retrieved with trephine. Before retrieval the implant was osseointegrated and not mobile. On one side of the implant, a 1 mm resorption of the crestal bone was present. On the contrary, on the other side no bone resorption had occurred and about 1 mm of bone was present over the implant shoulder. The bone-implant contact percentage was 65.1 ± 6.3 %. Platform- switching could help in maintaining the height of the peri-implant crestal bone.

Biological response of laser macrostructured and oxidized titanium alloy: An in vitro and in vivo study

To assess both the in vitro and in vivo biological response of a laser modified surface in an integrated manner. A combined innovative approach applies lasers to macrostructure as well as to oxidize the surface of titanium alloy implants. A Nd:YAG marking and ArF excimer lasers were used for macrostructuring and UV-oxidizing the surface of Ti6Al4V discs, respectively. Human fetal osteoblastic cell culture and a sheep tibia model were used to assess the cell response and the osseogeneration capability of as-machined, laser macrostructured and laser macrostructured and oxidized surfaces. In vitro: Laser macrostructuration alone did not promote cell response. Cellular proliferation was enhanced by the additional UV laser oxidation. In vivo: A greater significant percentage of bone-implant contact was obtained for both laser treated surfaces compared to machine-turned control samples, three months after implantation, in spite of the low cellular response for macrostructured samples. The use of sheep model for six months appears to be less adequate for a comparison because of the high level of bone integration in all samples. In spite of the often reported positive effect of titanium oxidation on the triggering of faster osseointegration, in this experiment the additional UV laser oxidation did not lead to a significant in vivo improvement. Laser macrostructuration of titanium alloy surfaces appears to promote bone apposition and may therefore constitute a promising surface modification strategy. In animal models, the natural process of titanium surface oxidation, because of physiologic fluids, alters properties observed in vitro with cells.

Peri-Implant Defect Augmentation With Autogenous Bone: A Study in Beagle Dogs

This study evaluates the success of immediate endosseous implants placed along with autogenous bone graft to fill the peri-implant gap. Thirty-two implants were inserted in 8 beagle dogs. The right and left lateral incisors in the maxilla and the mandible of all animals were extracted, and immediate postextraction implants were placed. In the control sites, no bone grafts or barrier membranes were used. In the contralateral experimental site, autogenous bone graft was used. The implants were retrieved with the jawbone for histomorphometric studies. The histomorphometric measurements were carried out using a computerized image analysis system. All implants were covered by compact, mature bone under examination in light microscopy. A high bone-implant contact percentage and bone density was observed at both grafted and nongrafted implant sites. The sites filled with autogenous bone graft showed a significantly higher crestal bone level and bone density compared to the nonfilled sites. The observations of the study emphasize that the filling of the peri-implant bone defects with autogenous bone grafts showed a better outcome compared to unfilled defects.

Biological limits of the undersized surgical technique: a study in goats

The purpose of the present study was to investigate the influence of different implant placement techniques on the early bone healing response in an animal model. In the present study, 24 cylindrical-screw-type implants with a diameter of 4.2 mm (Dyna®) were installed, using three different surgical techniques; (1) 5% undersized, using a final drill diameter of 4 mm; (2) 15% undersized, using a final drill diameter of 3.6 mm; and (3) 25% undersized, using a final drill diameter of 3.2 mm. After 3 weeks of implantation period, the peri-implant bone response was histologically evaluated and the percentage of bone-implant contact (%BIC) calculated. New bone formation was more pronounced for implants placed with the 5% undersized or 15% undersized technique, as compared with implants installed with the 25% undersized technique. Histomorphometrical data corroborates these findings as the %BIC was significantly higher for implants inserted with the 5% undersized (47.7 ± 11.1) or 15% undersized protocol (47.5 ± 9.5) as compared with implants inserted with the 25% undersized technique (32.1 ± 9.7). No significant difference in %BIC could be observed between the 5% undersized and 15% undersized installed implants. Within the limitation of the present study, it was concluded that excessive compression of the host bone, when a discrepancy between implant and final drill diameter more than 15%, can result in an inferior tissue response in the early stage of healing. To compare research results in the future, it is advised to specify the term "undersized" by mentioning the real reduction in diameter.

Effect of bone to implant contact percentage on bone remodelling surrounding a dental implant

Dental implants are an effective, safe and predictable solution for patients suffering from tooth loss, but implant placement changes the normal mechanical environment of the jawbone leading to bone density redistribution and 'remodelling', in order to adapt to the new environment. Many bone remodelling theories assume the presence of 100% contact between bone and implant, which is inconsistent with clinical reality. About 50-80% bone-implant contact is commonly seen with clinically successful implants. The influence of different percentages of bone-implant contact on bone remodelling has not been investigated adequately. This study aims to evaluate this influence using a newly proposed remodelling algorithm through a 2D finite element model. Four different degrees of bone-implant contact (25, 50, 75 and 100%) are considered and their influences on the density distribution of the jawbone are evaluated. The predicted results indicate that no matter what the initial percentage of bone-implant contact (25-100%), the final outcome is about 58-60% contact when an equilibrium state is reached by bone remodelling. The results are consistent with clinical observations and findings.

Osteoblast response and osseointegration of a Ti–6Al–4V alloy implant incorporating strontium

This study investigated the surface characteristics, in vitro and in vivo biocompatibility of Ti–6Al–4V alloy implants incorporating strontium ions (Sr), produced by hydrothermal treatment using a Sr-containing solution, for future biomedical applications. The surface characteristics were evaluated by scanning electron microscopy, thin-film X-ray diffractometry, X-ray photoelectron spectroscopy, optical profilometry, contact angle and surface energy measurement and inductively coupled plasma-mass spectroscopy (ICP-MS). Human osteoblast-like cell (MG63) attachment, proliferation, alkaline phosphatase (ALP) activity, and quantitative analysis of osteoblastic gene expression on Sr-containing Ti–6Al–4V surfaces were compared with untreated Ti–6Al–4V surfaces. Fifty-six screw implants (28 control and 28 experimental) were placed in the tibiae and femoral condyles of seven New Zealand White rabbits. The osteoconductivity of Sr-containing Ti–6Al–4V implants was evaluated by removal torque testing and histomorphometric analysis after 4 weeks implantation. Hydrothermal treatment produced a crystalline SrTiO 3 layer. ICP-MS analysis showed that Sr ions were released from treated surfaces into the solution. Significant increases in ALP activity ( P = 0.000), mRNA expressions of key osteoblast genes (osterix, bone sialoprotein, and osteocalcin), removal torque values ( P < 0.05) and bone–implant contact percentages ( P < 0.05) in both cortical and cancellous bone were observed for Sr-containing Ti–6Al–4V surfaces. The results indicate that the Sr-containing oxide layer produced by hydrothermal treatment may be effective in improving the osseointegration of Ti–6Al–4V alloy implants by enhancing differentiation of osteoblastic cells, removal torque forces and bone apposition in both cortical and cancellous bone.

Efficacy of a bioactive glass–ceramic (Biosilicate®) in the maintenance of alveolar ridges and in osseointegration of titanium implants

The aims of this research were to evaluate the efficacy of a bioactive glass-ceramic (Biosilicate) and a bioactive glass (Biogran) placed in dental sockets in the maintenance of alveolar ridge and in the osseointegration of Ti implants. Six dogs had their low premolars extracted and the sockets were implanted with Biosilicate, Biogran particles, or left untreated. After the extractions, measurements of width and height on the alveolar ridge were taken. After 12 weeks a new surgery was performed to take the final ridge measurements and to insert bilaterally three Ti implants in biomaterial-implanted and control sites. Eight weeks post-Ti implant placement block biopsies were processed for histological and histomorphometric analysis. The percentages of bone-implant contact (BIC), of mineralized bone area between threads (BABT), and of mineralized bone area within the mirror area (BAMA) were determined. The presence of Biosilicate or Biogran particles preserved alveolar ridge height without affecting its width. No significant differences in terms of BIC, BAMA, and BABT values were detected among Biosilicate, Biogran, and the non-implanted group. The results of the present study indicate that filling of sockets with either Biosilicate or Biogran particles preserves alveolar bone ridge height and allows osseointegration of Ti implants.

Osseointegration of Ti implants in buccal alveolar bone defect filled with bioactive glasses in dog mandible

AbstractAim: The aim of the present study was to investigate the amount of bone formation on titanium (Ti) implants in sites subjected to buccal alveolar crest defects and filled with different bone substitutes.Materials and methods: Mandibular premolars and first molars were extracted from five dogs. After 12 weeks, three implants (Neodent®, implant size: 3.75 × 9.0 mm, Curitiba, PR, Brazil) were bilaterally placed (total of 30 implants) in sites with buccal alveolar bone defects (length 45 mm, height 6 mm depth, 4 mm) created in the mandible. Each implantation site was randomly treated with Biosilicate (novel highly bioactive glass‐ceramic), Bioglass 45S5 (Biogran®, Implant Innovations, Barcelona, Spain), autogenous bone or no treatment. At 18 weeks after implantation, the hemi‐mandibles containing the implants were removed and processed for ground sections aiming to histological and histometric [bone‐implant contact (BIC), mineralised bone matrix between implant threads (BA) and bone matrix within mirror area (BMA)] analysis. Data were subjected to non‐parametric Kruskal–Wallis test.Results: The percentage of BIC, BA and mineralised BMA in the treated or non‐treated sites were not statistically different among the four experimental groups.Conclusion: These results indicate that the presence of the bone substitutes evaluated did not promote bone formation on Ti implants surface. In addition, tissue response to Biosilicate was similar to that of Bioglass 45S5 and autogenous bone.

An in vivo evaluation of surface polishing of TAN intermedullary nails for ease of removal

Fractures of the tibia and femoral diaphysis are commonly repaired by intra-medullary (IM) nailing. Currently IM nails are available in either electropolished stainless steel (SS) or in Titanium-Aluminium-Niobium (TAN). After healing, removal of the nails still is common but removal of TAN IM nails often has complications whereas SS IM nails of the same design are less often associated with problems. We believe the differences in removal are due to the ability of TAN to promote strong bone on-growth. We have previously shown in vivo that polishing cortical screws reduces removal torque and the percentage of bone-implant contact. Therefore, we postulate that bony on-growth onto IM nails can be reduced by means of surface polishing, for ease of removal. Here we aim to compare the pull-out forces for removal of standard TAN (TAN-S) compared to experimental paste polished TAN (TAN-PP) IM nails from a bilateral non-fracture sheep tibia model after 12 months implantation. Histological analysis was also performed to assess tissue on-growth to the nails. We show that polishing significantly reduces (p=0.05) the extraction force required for TAN IM nail removal. This effect in part is attributable to the distinct tissue-material reaction produced. For TAN-S nails direct bone contact was observed while for TAN-PP nails a fibrous tissue interface was noted. Since TAN is preferred over SS for IM nailing due to superior biocompatibility and mechanical properties, we believe these findings could be used to recommend changes to current surface technologies of intramedullary nails to reduce complications seen with nail removal especially in rapidly growing bone in children.

Is insertion torque correlated to bone–implant contact percentage in the early healing period? A histological and histomorphometrical evaluation of 17 human‐retrieved dental implants

A precise and scientifically established method for the evaluation of the bone quality/primary stability is the measure of the insertion torque (IT). The aim of this study was a comparison between the IT values and the bone-implant contact percentage (BIC) of human implants retrieved after a 4/8-week healing period. Seventeen implants, all with a sandblasted and acid-etched surface, were evaluated in the present study. The implants had been retrieved for different causes, after 4/8 weeks, with a 5 mm trephine bur, and immersed in 10% buffered formalin to be processed for histology. A not statistically significant correlation was found between IT and BIC (P<or=0.892). In the present study on human-retrieved implants, no statistically significant correlation was found between the IT values and BIC. These results could be due to a lack of relationship between bone structure and IT, or to the fact that primary stability may not only be influenced by bone volumetrical density and/or bone trabecular connectivity but also by the thickness and density of the cortical layer. Moreover, the present knowledge of the bone microstructure is not enough to explain the relationship of bone quality and primary implant stability.

Correlations between physical properties of jawbone and dental implant initial stability

There is confusion in the literature about how physical properties of bone vary between maxillary and mandibular regions and which physical properties affect initial implant stability. The purpose of this study was to determine correlations between physical properties of bone and initial implant stability, and to determine how physical properties and initial stability vary among regions of jawbone. Four pairs of edentulous maxillae and mandibles were retrieved from fresh human cadavers. Six implants per pair were placed in different anatomical regions (maxillary anterior, right and left maxillary posterior, mandibular anterior, right and left mandibular posterior). Immediately after surgery, initial implant stability was measured with a resonance frequency device and a tapping device. Implant surgeries and initial stability measurements were performed within 72 hours of death. Elastic modulus (EM) and hardness were measured using nano-indentation. Composite apparent density (cAD) was measured using Archimedes' principle. Bone-implant contact percentage and cortical bone thickness were recorded histomorphometrically. Mixed linear models and univariate-correlation analyses were used (alpha=.05). Generally, mandibular bone had higher initial implant stability and physical properties than maxillary bone. Initial implant stability was higher in the anterior region than in the posterior. EM was higher in the posterior region than in the anterior; the reverse was true for cAD. Of the properties evaluated, cAD had the highest correlation with initial implant stability (r=0.82). Both physical properties of bone and initial implant stability differed between regions of jawbone.

Early bone response to sandblasted, dual acid-etched and H2O2/HCl treated titanium implants: an experimental study in the rabbit

The aim of this study was to evaluate the influence of a roughened H(2)O(2)/HCl heat-treated titanium surface on peri-implant bone formation at an early stage in vivo. 24 Ti(6)Al(4)V alloy implants were used; half were treated by sandblasted and dual acid-etched treatments (control group), while the others were treated by sandblasted, dual acid-etched and H(2)O(2)/HCl heat treatments (test group). The morphology and roughness were analyzed by field emission SEM and atomic force microscopy. The implants were inserted into the femora of 12 adult white rabbits. After 2 and 4 weeks, femora block specimens were prepared for histological and histomorphometric analysis. SEM micrographs showed that multilevel and different sized pits were formed on both surfaces. New bone formation was observed on both implant surfaces. Test implants demonstrated a greater mean percentage of bone-implant contact as compared with controls at 2 (46.84 vs. 41.81, p=0.000) and 4 weeks (49.43 vs. 44.87, p=0.006) of healing. It is concluded that the H(2)O(2)/HCl heat-treated rough titanium surface promoted enhanced bone apposition during the early stages of new bone formation around the implant.