Bone Tissue Response Research Articles

Tissue response to polyglycolide, polydioxanone, polylevolactide, and metallic pins in cancellous bone: An experimental study on rabbits

The purpose of this study was to investigate, qualitatively and histoquantitatively, the tissue response of rabbit femur cancellous bone to polyglycolide (PGA), polydioxanone (PDS), polylevolactide (PLLA), and stainless steel pins under identical conditions. Eighty knees in 50 rabbits were operated on by inserting bioabsorbable pins (PGA, PDS, or PLLA) together with metallic Kirschner wire in 60, and two metallic Kirschner wires alone in 20 knees, while 20 knees served as intact controls. Follow-up times were 3, 6, 12, 24, and 52 weeks. Cancellous bone tissue response to implants was studied using histological, histomorphometrical, microradiographical, and oxytetracycline fluorescence methods. Residual fragments of PGA and PDS were seen at 24 weeks. Complete degradation of these polymers had taken place before 52 weeks. No signs of degradation of the PLLA pins were observed within the entire follow-up period. The osteoid formation surfaces at tissue implant-interface were statistically larger in all test groups as compared to intact controls. The number of macrophages at tissue implant-interfaces increased in all bioabsorbable implant specimens until 6 weeks, and with PGA until 12 weeks. No differences in the osseous response emerged when comparing groups of bioabsorbable implants with each other or with stainless steel group. Bioabsorbable pins and metallic Kirschner wires evoked an osteoconductive response in the cancellous bone surrounding implant, but the response intensity between implants displayed no differences. This suggests a simple, nonspecific walling-off new-bone front type of response. Consequently, the polymers possessed no specific osteostimulatory or osteoinhibitory properties. Within the follow-up, no significant differences in biocompatibility between the implants appeared, and no frank inflammatory foreign-body reactions occurred. The small-volume pins obviously did not exceed the local tissue tolerance and clearing capacity of the bone.

Biomechanical and Histomorphometric Analyses of Monocortical Screws at Placement and 6 Weeks Postinsertion

Maxillofacial screws are increasingly being used in orthodontics to provide anchorage for tooth movement. The objective of this study was to determine the biomechanical stability as well as the bone tissue response of screws at 6 weeks postinsertion in a canine model. Seven skeletally mature male dogs received 102 screws (2 x 6 mm or 2 x 8 mm) at predetermined sites. Twenty screws became loose or were lost during the 6-week undisturbed healing period. Forty-eight screws were randomized for mechanical testing and 34 for histology. Peak pullout strength was recorded and approximately 80-microm sections were examined for histomorphometric parameters. Statistical analyses were conducted by analysis of variance and Tukey-Kramer method. Mean +/- SE peak pullout strengths for the various sites ranged from 153.5 +/- 37.6 N to 389.3 +/- 32.5 N with no significant (P < .05) differences at immediate placement and 6 weeks postinsertion. Bone contact ranged from 79% to 95%. Histomorphometric analyses indicated higher bone formation rate in the mandible than in the maxilla and a gradient of decreasing turnover with increasing distance from the screw interface. These results provide the clinical orthodontist with an estimate of the holding power of these screws and an understanding of early biological healing response associated with self-drilling screws.

Bone Reformation and Implant Integration following Maxillary Sinus Membrane Elevation: An Experimental Study in Primates

Recent clinical studies have described maxillary sinus floor augmentation by simply elevating the maxillary sinus membrane without the use of adjunctive grafting materials. This experimental study aimed at comparing the histologic outcomes of sinus membrane elevation and simultaneous placement of implants with and without adjunctive autogenous bone grafts. The purpose was also to investigate the role played by the implant surface in osseointegration under such circumstances. Four tufted capuchin primates had all upper premolars and the first molar extracted bilaterally. Four months later, the animals underwent maxillary sinus membrane elevation surgery using a replaceable bone window technique. The schneiderian membrane was kept elevated by insertion of two implants (turned and oxidized, Brånemark System, Nobel Biocare AB, Göteborg, Sweden) in both sinuses. The right sinus was left with no additional treatment, whereas the left sinus was filled with autogenous bone graft. Implant stability was assessed through resonance frequency analysis (Osstell, Integration Diagnostics AB, Göteborg, Sweden) at installation and at sacrifice. The pattern of bone formation in the experimental sites and related to the different implant surfaces was investigated using fluorochromes. The animals were sacrificed 6 months after the maxillary sinus floor augmentation procedure for histology and histomorphometry (bone-implant contact, bone area in threads, and bone area in rectangle). The results showed no differences between membrane-elevated and grafted sites regarding implant stability, bone-implant contacts, and bone area within and outside implant threads. The oxidized implants exhibited improved integration compared with turned ones as higher values of bone-implant contact and bone area within threads were observed. The amount of augmented bone tissue in the maxillary sinus after sinus membrane elevation with or without adjunctive autogenous bone grafts does not differ after 6 months of healing. New bone is frequently deposited in contact with the schneiderian membrane in coagulum-alone sites, indicating the osteoinductive potential of the membrane. Oxidized implants show a stronger bone tissue response than turned implants in sinus floor augmentation procedures.

Histologic Evaluation of Brånemark Clinic Oral Implants Retrieved from Grafted Sites

The aim of this report is to quantitatively and qualitatively describe the bone tissue response to Brånemark implants retrieved from grafted sites in patients. The material consists of consecutively received Brånemark implants retrieved from grafted sites. Thirty-five of these implants, retrieved from 16 patients, were suitable for the histologic evaluation of undecalcified sections in the light microscope. The unloaded implants were mainly lined with soft tissue, and sparse bone-implant contact was observed only in some sections. The loaded implants, with the exception of one implant removed due to mobility, had mature and new bone-implant contact. Resorption of graft through cutting cone structures was detected. Cement lines were found separating bone-like tissue albeit no cellular content and bone tissue with detectable osteocytes. In this heterogeneous group of implants from grafted sites, the unloaded implants showed limited bone-implant contact. The autografts showed seemingly mixed viability as judged by the cell content in the osteocyte lacunae and cement lines separating areas with filled and empty lacunae.

Collagen Fiber Orientation Near a Fractured Dental Implant After a 5-Year Loading Period: Case Report

Fracture of an implant is one of the possible complications of dental implants. It is a quite rare event but of high clinical relevance. Nevertheless, it represents an important opportunity for evaluating the peri-implant bone-tissue response to implant overloading in human beings. The aim of the present study was a scanning electron microscopy evaluation of a screw-shaped implant retrieved because of fracture and a birefringence analysis of the tissue near the fractured implant. There was 1 fractured screw-shaped implant retrieved from a patient with a trephine bur, and it was processed for histology. The specimen was analyzed under both scanning electron microscopy and circularly polarized light microscopy. The scanning electron microscopy fractography analysis showed the typical signs of a fatigue-fracture, with large plastic deformations on the implant. The fracture seemed to start from the internal coil of the implant. Under circularly polarized light microscopy investigation, a bone-implant contact percentage of 81.6% +/- 1.5% (mean +/- standard deviation) was found. The amount of the transverse collagen fibers was of 68.3%, and the amount of the longitudinal collagen fibers was of 31.7%. The difference was statistically significant for z = 2.247 (P = 0.025). The fracture of the implant was most probably correlated to a fatigue of the material mainly associated to a lesion of the internal coil. The high level of bone-implant contact percentage was correlated to a predominant transverse collagen fiber orientation of the collagen fibers in the peri-implant bone.

Osteoinductivity of HAp Films with Different Surface Morphologies Coated by the Thermal Substrate Method in Aqueous Solutions

The aim of this study was to investigate the in vivo performance of implants coated with hydroxyapatite (HAp) with different surface morphologies. HAp coatings were formed on commercially pure titanium rods (2 mm in diameter, 5 mm in length) by the thermal substrate method in an aqueous solution that included Ca(H2PO4)2 and CaCl2. The coating experiments were conducted at 40–140 � C and pH ¼ 8 for 15 or 30 min. All the specimens were covered with HAp, which had different morphologies such as net-like, plate-like, and needle-like. The coated rods were implanted in the tibiae of 10-week-old male rats. Noncoated titanium rods were used as the control in this study. The constructs were retrieved 14, 28, and 56 days postimplantation and examined for new bone formation and tissue response in the cancellous and cortical bone, respectively. After 14 days implantation, new bone formed on both the HAp-coated and noncoated titanium rods in the cancellous and cortical bone. However, the bone-implant contact ratio, which was used for the evaluation of new bone formation, was significantly dependent on the surface morphology of the HAp, and the results demonstrated that the needle-like coating appears to promote rapid bone formation. [doi:10.2320/matertrans.47.1391]

Corrosion Resistance, Mechanical Properties, Fatigue Properties, and Tissue Response of Ti-15Zr-4Nb-4Ta Alloy

Abstract Ti, Zr, Nb, and Ta are biocompatible elements. A Ti-15Zr-4Ta-4Nb alloy for medical implants is being developed. In terms of in vitro cytocompatibility, the new bone tissue response to the Ti-15Zr-4Ta-4Nb alloy determined through rat tibia implantation was equal to or better than that to the Ti-6Al-4V alloy. An acceptable level of biological response can be expected when this alloy is used appropriately because it consists of biocompatible elements and has excellent biocompatibility, corrosion resistance, microstructure, and mechanical and fatigue properties. Therefore, the Ti-15Zr-4Ta-4Nb alloy with a low metal release rate is considered advantageous for long-term surgical implants.

Interface reaction at dental implants inserted in condensed bone

The influence of the osteotome technique on the interface reaction of cylinder implants (SLA, ITI) was compared with the interface reaction of conventional implant insertion in an animal model. A total of 64 implants were placed in the cranial and caudal tibia of 8 Göttinger minipigs. The implant site was prepared either by a conventional technique with drills (control group A) or by the osteotome technique (experimental group B). Bone tissue responses were evaluated by histomorphometry, fluorescence microscopy and scanning electron microscopy after 7 and 28 days of osseointegration. The average initial (7 days) bone-to-implant contact ratio was not statistically significantly different for the osteotome technique (35.88+/-2.94%) than for the control group (43.78+/-3.39%, P<0.095). After 28 days, the bone-to-implant contact ratio became statistically significantly higher when implants were inserted by conventional preparation (44.81+/-3.07% (group B), 63.47+/-4.87% (group A), P=0.003). Whereas fluorescence and immunhistologic examination revealed new bone formation with osteocalcin deposition directly at the implant surface in both groups, the extent of direct bone/implant contact was enhanced in conventionally prepared implant sites. SEM analysis confirmed an intimate bone to implant bond without fibrous tissue formation in places of direct contact at an ultrastructured level. Implant placement in conventionally prepared implantation sites is accompanied by an improved interface formation at an early stage of implantation.

Bone Tissue Response to a Methacrylate-Based Endodontic Sealer: A Histological and Histometric Study

Biocompatibility of endodontic sealers is a prime requisite for successful endodontic therapy. The purpose of this study was to evaluate the reaction of bone to a methacrylate-based endodontic sealer. Silicone tubes, filled with a methacrylate-based sealer and silicone rods used as controls, were implanted in the tibias of white male Wistar rats. Ten and 60 days after implantation the reaction of the bone was analyzed by means of histological and histometric methods. After 10 days the amount of reactionary bone in contact with the methacrylate-based sealer was significantly lower than that observed for the controls (p < 0.05). Cell counts demonstrated that the number of inflammatory cells that were in contact with the sealer were significantly higher (p < 0.05). After 60 days, no significant differences were observed in the amount of reactionary bone that was in contact with either material. The initial inflammatory reaction observed for the methacrylate-based sealer was resolved. Furthermore the cell counts demonstrated no statistically significant differences (p > 0.05) between the methacrylate based sealer and control.

Bone Tissue Responses to Surface‐Modified Zirconia Implants: A Histomorphometric and Removal Torque Study in the Rabbit

Zirconia ceramics are biocompatible and have mechanical properties that make them suitable as materials for dental implants. Little is known about how surface modification influences the stability and bone tissue response to zirconia implants. The objective of the investigation was to histologically and biomechanically evaluate the bone tissue response to zirconia implants with two different surface modifications in comparison with machined, nonmodified zirconia implants and oxidized titanium implants. Threaded zirconia implants with a diameter of 3.75 mm with either a machined surface (Zr-Ctr) or one of two surface modifications (Zr-A and Zr-B) were manufactured. Oxidized titanium (Ti-Ox) implants 3.75 mm in diameter were also used. The implants were characterized with regard to surface topography using an interferometer. Twelve rabbits received 96 implants using a rotational scheme, two in each tibia and two in each femur. The implants in six rabbits were subjected to removal torque (RTQ) tests after a healing period of 6 weeks. The implants in the remaining six animals were removed en bloc for light microscopic analysis. Back-scatter scanning electron microscopic (BS-SEM) analyses were used to evaluate the state of the bone-implant interface at the modified zirconia implants after RTQ testing. The Ti-Ox and Zr-A implants showed the highest surface roughness, followed by the Zr-B implants and, finally, the Zr-Ctr implants. The nonmodified ZrO2 implants showed statistically significant lower RTQs than all other implants. No significant differences in bone-implant contact or bone area filling the threads were observed. BS-SEM showed intact surface layers of the surface-modified implants after RTQ testing and revealed fracture of the interface bone rather than a separation. The present study showed a strong bone tissue response to surface-modified zirconia implants after 6 weeks of healing in rabbit bone. The modified zirconia implants showed a resistance to torque forces similar to that of oxidized implants and a four- to fivefold increase compared with machined zirconia implants. The findings suggest that surface-modified zirconia implants can reach firm stability in bone.

Mechanical Properties and Osteoconductivity of Porous Bioactive Titanium Metal

Porous bioactive titanium implant was produced by plasma-spray method and succeeding chemical and thermal treatment. This porous titanium implant possess a porosity of 40% and complex interconnective porous structure. Mechanical property of porous titanium was characterized for compressive and 4-point bending properties, as well as compressive fatigue. Bone tissue response and biocompatibility of porous bioactive titanium implant was evaluated by in vivo osteoconductive model. Ultimate compression strength and bending strength were 280 and 101 MPa. Bone ingrowth showed significant increases in treated implant, while in these untreated porous titanium implant, bone ingrowth seemed to decrease with time. These results suggest that porous bioactive titanium is a candidate for clinical applications under load-bearing conditions.

Bone Formation at Titanium Implants Prepared with Iso- and Anisotropic Surfaces of Similar Roughness: An in Vivo Study

Implant surface topography influences the bone response after implantation. However, the importance of surface orientation is not known. The aim of this study was to investigate the bone tissue response and the stability of titanium implants prepared with isotropic and anisotropic surfaces of similar roughness. A total of 18 implants were divided into two groups and were inserted into the femurs of nine rabbits for 12 weeks. Confocal laser scanning microscopy was used for the topographic description to verify that the two different surfaces were modified as intended. The stability of the implants was recorded by resonance frequency (RF) measurements at insertion and at time of removal, after which the implants were evaluated histomorphometrically. RF measurements showed that implant stability increased with time. However, there was no significant difference between the two different surface modifications at insertion and after 12 weeks. The histomorphometric comparison revealed no statistically significant differences in regard to either bone-to-metal contact or bone area inside the threads. Titanium implants prepared with isotropic and anisotropic surfaces of similar roughness integrate similarly to bone during the 3 months after implantation.

Adrenal Steroid Hormones and Metaphyseal Bone in Children

Background/Objectives: The responses of metaphyseal bone tissue to physiological variations of endogenous adrenal steroid hormones during childhood are unclear. Therefore, we studied potential hormonal influences in children before the appearance of pubic hair (onset of pubarche). Methods: Excretions of major glucocorticoid metabolites (C21), cortisol, sum of adrenarchal dehydroepiandrosterone and its immediate 16-hydroxylated metabolites (DHEA&M), and 5-androstene-3β,17β-diol (hermaphrodiol) were analyzed in a cross-sectional study in 24-hour urine samples of 109 healthy boys and girls, aged 6–13 years, using steroid profiling by gas chromatography-mass spectrometry. Total and trabecular volumetric bone mineral densities, bone mineral content (BMC) and bone strength strain index were determined with peripheral quantitative computed tomography at the distal forearm. Results: In multiple regression analyses significant associations with the metaphyseal radius were seen for grip force, age, or BMI depending on gender and bone variable analyzed. DHEA&M did not contribute to the explanation of the variance of any bone variable. However, hermaphrodiol positively explained a significant part of variation of bone mineral densities, and BMC (p < 0.01) in girls. Significantly negative associations with all bone variables were seen in boys for cortisol. Conclusions: The steroid hormones, cortisol and hermaphrodiol, in their physiological ranges, but not the adrenarche marker DHEA&M, appear to associate with metaphyseal bone in a sex-dependent manner during childhood.

Biological and biomechanical evaluation of bone remodelling and implant stability after using an osteotome technique

The influence of the osteotome technique on the osseointegration and biomechanical behaviour of cylinder implants (SLA, ITI was compared with conventional preparation of the implant site in an animal model. A total of 56 implants were placed in the cranial and caudal tibia condyle of six Gottinger minipigs. The implant site was prepared either by the conventional technique with drills (control group A) or by the osteotome technique (experimental group B). Resonance frequency measurements (RFMs) were made on each implant at the time of fixture placement and at the time of scarification. Half of the minipigs were sacrificed 7 days and 28 days after implant placement and the implants were removed with the surrounding bone. Bone tissue responses were evaluated by histological analysis and removal torque testing. For histological evaluation 30-50 microm-thick ground sections were examined. Biomechanical testing revealed a significantly higher stability of implants in the control group (A) than in the experimental group (B) (P = 0.004) at day 7. After 28 days implant stability in the control group remained significant higher (47%) than those of group B (P > 0.001). RFM demonstrated no significant difference between both groups and during the experimental course. Histological analysis demonstrated fractured trabeculae in peri-implant bone in the experimental group at day 7, while they were not posed at day 28. We conclude that the decreased implant stability by using the osteotome technique is based on microfractures in peri-implant bone.

Responsiveness of Muscle, Bone and Connective Tissue to Physical Activity: Generic and Molecular Integration SA5-SA6

Responsiveness of Muscle, Bone and Connective Tissue to Physical Activity: Generic and Molecular Integration SA5-SA6

Porous TiNi Biomaterial by Self‐Propagating High‐Temperature Synthesis

AbstractPorous TiNi shape‐memory alloy (TiNi SMA) bodies with controlled pore structure were produced from the (Ti+Ni) powder mixture by self‐propagating high‐temperature synthesis (SHS) method. The effect of processing variables such as the kind of starting powders, ignition temperature and preheating schedule on the behavior of combustion wave propagation, the formation of phases and pore structure was investigated. The relationship between pore structure and mechanical properties was also investigated. An in vivo test was performed to evaluate bone tissue response and histocompatibility of porous TiNi SMA using 15 New Zealand white rabbits. No apparent adverse reactions such as inflammation and foreign body reaction were noted on or around all implanted porous TiNi SMA blocks. Bone ingrowth was found in the pore space of all implanted blocks.

Some Biomechanical and Histologic Characteristics of Early‐Loaded Locking Pin and Expandable Implants: A Pilot Histologic Canine Study

A two-stage approach with a 3- to 6-month healing period is recommended for the "conventional" osseointegration technique with oral implants. This may induce inconvenience and discomfort for patients, and immediate early loading protocols are preferable. To compare a new type of implant with two locking pins, designed to allow immediate loading, with an expandable implant design with regard to bone tissue response and implant stability. The molars and premolars of two beagle dogs were extracted in the mandible, and two types of implants (an apically expandable implant and a locking pin implant) were immediately placed in the sockets. The dogs received at least four implants (two of each type) in each side of the mandible. Implants were loaded with gold-palladium bridges 15 days later. The loaded implants were left for 3 months, and the dogs were sacrificed. Resonance frequency analysis (RFA) was performed at placement and sacrifice. Ground sections for histomorphometry were produced for each implant. Implant stability as measured by RFA was similar for the two types of implants before healing. At termination of the study, stability was higher for the locking pin implants. Bone histomorphometry showed that both types of implant were anchored by the same amount of bone and that bone-titanium interfaces did not differ. The locking pin implant showed better secondary stability than did the expandable implant, probably because of a better transmission of strains to bone.

Porous TiNi Biomaterial Produced by Self-Propagating High-Temperature Synthesis: Pore Structure, Mechanical Property and Application

Porous TiNi shape-memory alloy (TiNi SMA) bodies were produced from the (Ti+Ni) powder mixture by self-propagating high-temperature synthesis (SHS) method. Various processing variables such as ignition temperature and heating schedule were used to control the pore structure. Relationship between pore structure and mechanical property was also investigated. An in vivo test was performed to evaluate bone tissue response and biocompatibility of porous TiNi SMA. It showed no apparent adverse reactions such as inflammation and foreign body reaction. Bone ingrowth was found in the pore space of all implanted blocks. Introduction Titanium-nickel intermetallic compound is well known as one

Leptin deficiency produces contrasting phenotypes in bones of the limb and spine

Leptin is a hormone secreted by adipocytes that can regulate bone mass through a central, neuroendocrine signaling pathway. We tested the hypothesis that the response of bone tissue to altered leptin signaling is not uniform throughout the skeleton, but may vary between different skeletal regions and between cortical and trabecular moieties. We investigated the effects of leptin deficiency on muscle mass and bone architecture in obese, leptin-deficient (ob/ob) mice, and in lean controls. Results indicate that the obese mice weigh approximately twice as much as the lean mice, but the quadriceps muscles of the ob/ob mice are 40% smaller than those of controls. Leptin-deficient mice have significantly shorter femora, lower femoral bone mineral content (BMC), bone mineral density (BMD), cortical thickness, and trabecular bone volume compared to lean mice. Marrow tissue from the femora of ob/ob mice also shows a marked increase in adipocyte number compared to that of normal mice. In contrast to the pattern observed in the femur, ob/ob mice have significantly increased vertebral length, lumbar BMC, lumbar BMD, and trabecular bone volume compared to lean controls. Few adipocytes are observed in bone marrow from lumbar vertebrae of ob/ob mice, despite being numerous in marrow of the femur. However, like the femur, significant cortical thinning is also observed in the spine. These results indicate that the effects of altered leptin signaling on bone differ significantly between axial and appendicular regions, and may be mediated in part by muscle mass. The muscle hypoplasia, increased marrow adipogenesis, and decreased bone mass observed in the hindlimbs of ob/ob mice are also observed with aging in humans, suggesting that the ob/ob mouse may be a new and useful animal model for studying the relationship between bone marrow adipogenesis and osteopenia.

Influence of the in vitro culture period on the in vivo performance of cell/titanium bone tissue-engineered constructs using a rat cranial critical size defect model.

The aim of this study was to investigate the in vivo performance in bone-regenerating capability of cell/scaffold constructs implanted into an orthotopic site. Bone marrow stromal osteoblasts were seeded on titanium fiber mesh scaffolds using a cell suspension (5 x 10(5) cells per scaffold) and cultured for 1, 4, and 8 days under either static or flow perfusion conditions forming six different treatment groups. A total of 16 constructs from each one of the six treatment groups were then implanted into an 8-mm critical size calvarial defect created in the cranium of adult syngeneic male Fisher rats. Half of the constructs from each group were retrieved 7 days postimplantation, and the other half of the constructs were retrieved 30 days postimplantation and examined for new bone formation and tissue response. Constructs retrieved 7 days postimplantation were filled with fibrous tissue and capillaries, but no bone formation was observed in any of the six treatment groups. Constructs retrieved 30 days postimplantation showed bone formation (at least 7 out of 8 constructs in all treatment groups). Titanium fiber meshes seeded with bone marrow stromal osteoblasts and cultured for 1 day under flow perfusion conditions before implantation appeared to give the highest percentage of bone formation per implant (64 +/- 17%). They also showed the highest ratio of critical size cranial defects that resulted in union of the defect 30 days postimplantation (7 out of 8) together with the constructs cultured for 1 day under static conditions before implantation. There were no significant differences between the different treatment groups; this finding is most likely due to the large variability of the results and the small number of animals per group. However, these results show that titanium fiber mesh scaffolds loaded with bone marrow stromal osteoblasts can have osteoinductive properties when implanted in an orthotopic site. They also indicate the importance of the stage of the osteoblastic differentiation and the quality of the in vitro generated extracellular matrix in the observed osteoinductive potential.