Early Stages Of Osseointegration Research Articles

Implant surface modifications and their impact on osseointegration and peri-implant diseases through epigenetic changes: A scoping review.

Dental implant surfaces and their unique properties can interact with the surrounding oral tissues through epigenetic cues. The present scoping review provides current perspectives on surface modifications of dental implants, their impact on the osseointegration process, and the interaction between implant surface properties and epigenetics, also in peri-implant diseases. Findings of this review demonstrate the impact of innovative surface treatments on the epigenetic mechanisms of cells, showing promising results in the early stages of osseointegration. Dental implant surfaces with properties of hydrophilicity, nanotexturization, multifunctional coatings, and incorporated drug-release systems have demonstrated favorable outcomes for early bone adhesion, increased antibacterial features, and improved osseointegration. The interaction between modified surface morphologies, different chemical surface energies, and/or release of molecules within the oral tissues has been shown to influence epigenetic mechanisms of the surrounding tissues caused by a physical-chemical interaction. Epigenetic changes around dental implants in the state of health and disease are different. In conclusion, emerging approaches in surface modifications for dental implants functionalized with epigenetics have great potential with a significant impact on modulating bone healing during osseointegration.

Nanoscaled Titanium Oxide Layer Provokes Quick Osseointegration on 3D-Printed Dental Implants: A Domino Effect Induced by Hydrophilic Surface.

Three-dimensional printing is a revolutionary strategy to fabricate dental implants. Especially, 3D-printed dental implants modified with nanoscaled titanium oxide layer (H-SLM) have impressively shown quick osseointegration, but the accurate mechanism remains elusive. Herein, we unmask a domino effect that the hydrophilic surface of the H-SLM facilitates blood wetting, enhances the blood shear rate, promotes blood clotting, and changes clot features for quick osseointegration. Combining computational fluid dynamic simulation and biological verification, we find a blood shear rate during blood wetting of the hydrophilic H-SLM 1.2-fold higher than that of the raw 3D-printed implant, which activates blood clot formation. Blood clots formed on the hydrophilic H-SLM demonstrate anti-inflammatory and pro-osteogenesis effects, leading to a 1.5-fold higher bone-to-implant contact and a 1.8-fold higher mechanical anchorage at the early stage of osseointegration. This mechanism deepens current knowledge between osseointegration speed and implant surface characteristics, which is instructive in surface nanoscaled modification of multiple 3D-printed intrabony implants.

Employing Indirect Adenosine 2A Receptors (A2AR) to Enhance Osseointegration of Titanium Devices: A Pre-Clinical Study.

The present study aimed to evaluate the effect of dipyridamole, an indirect adenosine 2A receptors (A2AR), on the osseointegration of titanium implants in a large, translational pre-clinical model. Sixty tapered, acid-etched titanium implants, treated with four different coatings ((i) Type I Bovine Collagen (control), (ii) 10 μM dipyridamole (DIPY), (iii) 100 μM DIPY, and (iv) 1000 μM DIPY), were inserted in the vertebral bodies of 15 female sheep (weight ~65 kg). Qualitative and quantitative analysis were performed after 3, 6, and 12 weeks in vivo to assess histological features, and percentages of bone-to-implant contact (%BIC) and bone area fraction occupancy (%BAFO). Data was analyzed using a general linear mixed model analysis with time in vivo and coating as fixed factors. Histomorphometric analysis after 3 weeks in vivo revealed higher BIC for DIPY coated implant groups (10 μM (30.42% ± 10.62), 100 μM (36.41% ± 10.62), and 1000 μM (32.46% ± 10.62)) in comparison to the control group (17.99% ± 5.82). Further, significantly higher BAFO was observed for implants augmented with 1000 μM of DIPY (43.84% ± 9.97) compared to the control group (31.89% ± 5.46). At 6 and 12 weeks, no significant differences were observed among groups. Histological analysis evidenced similar osseointegration features and an intramembranous-type healing pattern for all groups. Qualitative observation corroborated the increased presence of woven bone formation in intimate contact with the surface of the implant and within the threads at 3 weeks with increased concentrations of DIPY. Coating the implant surface with dipyridamole yielded a favorable effect with regard to BIC and BAFO at 3 weeks in vivo. These findings suggest a positive effect of DIPY on the early stages of osseointegration.

Impact of a Static Magnetic Field on Early Osseointegration: A Pilot Study in Canines.

A static magnetic field generated by neodymium-iron-boron (NdFeB) magnets placed in the inner cavity of dental implants can enhance bone regeneration in rabbits. It is, however, unknown whether static magnetic fields support osseointegration in a canine model. We therefore determined the potential osteogenic effect of implants carrying NdFeB magnets inserted in the tibia of six adult canines in the early stages of osseointegration. Here, we report that after 15 days of healing, magnetic and regular implants showed a high variation with a median new bone-to-implant contact (nBIC) in the cortical (41.3% and 7.3%) and the medullary (28.6% and 44.8%) region, respectively. Consistently, the median new bone volume/tissue volume (nBV/TV) in the cortical (14.9% and 5.4%) and the medullary (22.2% and 22.4%) region were not significantly different. One week of healing only resulted in negligible bone formation. These findings suggest that considering the large variation and the pilot nature of this study, magnetic implants failed to support peri-implant bone formation in a canine model.

Effect of the Magnetic Field Generated by a New NeFeB Cover Screw on Bone Healing around Endosseous Implants: A Case Series Report from Dental Practice

This study aimed to investigate the effect of static magnetic field (SMF) generated by innovative cover screws made of NeFeB on early bone healing around dental implants. The study was carried out on humans in a private dental practice. Eight 3i implants (Biomet, Palm Beach, FL, USA) were placed in the posterior mandible at 3.6 and 3.7. The control implants were closed with a conventional screw (G1), while the test implants were closed with a Supercharged® screw (G2). Both groups were compared for stability at 0, 7, 14, 21, 50, and 90 days using a resonant frequency analyzer with Ostell Mentor (Osstell AB, Gothenburg, Sweden). After 50 days, the Supercharged® cover screw was removed. A significant increase in implant stability quotient (ISQ), corresponding to a lower degree of bone resorption, was observed in G2 throughout the follow-up period (p < 0.05), while an initial ISQ decrease was observed until day 21 in G1. In conclusion, the effect of SMF seems to be in the early stages of osseointegration and increases the stability of dental implants.

Bone Response to Osteopontin-Functionalized Carboxyethylphosphonic Acid-Modified Implants. Experimental Study in a Minipig Model

Currently, dental implants have become a common and reliable treatment for restoring masticatory function in edentulous patients. Their surface topography is of great importance for the adhesion and remodeling of bone cells, both in the initial phases and over time, and different strategies have been proposed to improve the biological performance of conventional sandblasted, large-grit, acid-etched implant surfaces. Corrosion has been identified as one of the causes of implant failure due to contact with oral fluids. Carboxyethylphosphonic acid is a potent anticorrosive that would form stable bonds with titanium oxide, generating an organic layer on which modifications could be made to improve cell adhesion. Osteopontin is considered a molecule capable of improving the osseointegration of titanium. Our study evaluated the osseointegration capacity of titanium implants modified with carboxyethylphosphonic acid and functionalized with osteopontin in a minipig model. A total of 16 implants were inserted in the tibial diaphysis of two minipigs, 8 implants modified with carboxyethylphosphonic acid and functionalized with osteopontin from the experimental group and 8 from the control group with sandblasted, large-grit, acid-etched surface treatment. After 4 weeks, the animals were sacrificed and the samples were analyzed by histomorphometric analysis, assessing bone-implant contact, cortical bone-implant contact, percentage of new bone, peri-implant bone density and interthread bone area interthread. Statistical analysis was performed using SPSS v.18. Statistical significance was found between groups for the percentage of new bone (p = 0.04) and for interthread bone area interthread (p = 0.01). Functionalization of titanium surfaces by osteopontin may be of interest for conditioning bone remodeling in the early stages of osseointegration, although more in vivo studies are needed to determine its real influence in this aspect.

Effects of local single dose administration of parathormone on the early stages of osseointegration: A pre-clinical study.

The present study aimed to evaluate the effect of parathormone (PTH) administered directly to the implant's surface prior to insertion, using a large translational animal model. Sixty titanium implants were divided into four groups: (i) Collagen, control group, where implants were coated with Type-I Bovine-collagen, and three experimental groups, where implants received varying doses of PTH: (ii) 12.5, (iii) 25, and (iv) 50 μg, prior to placement. Fifteen female sheep (~2 years old, weighing ~65 kg) received four implants in an interpolated fashion in C3, C4 or C5 vertebral bodies. After 3-, 6- and 12-weeks, samples were harvested, histologically processed, qualitatively and quantitatively assessed for bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO). BIC yielded lower values at 6-weeks for 50 μg relative to the control group, with no significant differences, when compared to the 12.5- and 25-μg. No significant differences were detected at 6-weeks between collagen, 12.5- and 25-μg groups. At 3- and 12-weeks, no differences were detected for BIC among PTH groups. With respect to BAFO, no significant differences were observed between the control and experimental groups independent of PTH concentration and time in vivo. Qualitative observations at 3-weeks indicated the presence of a more mature bone near the implant's surface with the application of PTH, however, no significant differences in new bone formation or healing patterns were observed at 6- and 12-weeks. Single local application of different concentrations of PTH on titanium implant's surface did not influence the osseointegration at any time-point evaluation in low-density bone.

Effect of supplemental acid-etching on the early stages of osseointegration: A preclinical model

PurposeTo evaluate the effect of two surface modifications on early osseointegration parameters of conical implants in a translational pre-clinical model. Materials and methodsConical implants with progressive trapezoidal threads and healing chambers were evaluated consisting of two different surface conditions: 1) Implacil surface (IMP Sur), and 2) Implacil surface + Supplemental Acid-etching (IMP Sur + AE). Surface characterization comprised of the evaluation of roughness parameters (Sa, Sq and Sdr), surface energy and contact angle. Subsequently, implants were installed in the ilium crest of nine female sheep (weighing ~65 kg). Torque out, histological and histomorphometric analyses were conducted after 3 and 6 weeks in-vivo. The percentage of bone to implant contact (%BIC) and bone area fraction occupancy within implant threads (%BAFO) were quantified, and the results were analyzed using a general linear mixed model analysis as function of surface treatment and time in-vivo. ResultsSupplemental acid etching significantly increased Sa and Sq roughness parameters without compromising the surface energy or contact angle, and no significant differences with respect to Sdr. Torque-out testing yielded significantly higher values for IMP Sur + AE in comparison to the IMP Sur at 3- (62.78 ± 15 and 33.49 ± 15 N.cm, respectively) and 6-weeks (60.74 ± 15 and 39.80 ± 15 N.cm, respectively). Histological analyses depicted similar osseointegration features for both surfaces, where an intramembranous-type healing pattern was observed. At histomorphometric analyses, IMP Sur + AE implants yielded higher values of BIC in comparison to IMP Sur at 3- (40.48 ± 38 and 27.98 ± 38%, respectively) and 6-weeks (45.86 ± 38 and 34.46 ± 38%, respectively). Both groups exhibited a significant increase in %BAFO from 3 (~35%) to 6 weeks (~44%), with no significant differences between surface treatments. ConclusionSupplemental acid-etching and its interplay with implant thread design, positively influenced the BIC and torque-out resistance at early stages of osseointegration.

Current interpretations on the in vivo response of bone to additively manufactured metallic porous scaffolds: A review

Recent advances in the field of metallic additive manufacturing have expanded production capabilities for bone implants to include porous lattice structures. While traditional models of de novo bone formation can be applied to fully dense implant materials, their applicability to the interior of porous materials has not been well-characterized. Unlike other reviews that focus on materials and mechanical properties of lattice structures, this review compiles biological performance from in vivo studies in pre-clinical models only. First, we introduce the most common lattice geometry designs employed in vivo and discuss some of their fabrication advantages and limitations. Then lattice geometry is correlated to quantitative (histomorphometric) and qualitative (histological) assessments of osseointegration. We group studies according to two common implant variables: pore size and percent porosity, and explore the extent of osseointegration using common measures, including bone-implant contact (BIC), bone area (BA), bone volume/total volume (BV/TV) and biomechanical stability, for various animal models and implantation times. Based on this, trends related to in vivo bone formation on the interior of lattice structures are presented. Common challenges with lattice structures are highlighted, including nonuniformity of bone growth through the entirety of the lattice structure due to occlusion effects and avascularity. This review paper identifies a lack of systematic in vivo studies on porous AM implants to target optimum geometric design, including pore shape, size, and percent porosity in controlled animal models and critical-sized defects. Further work focusing on surface modification strategies and systematic geometric studies to homogenize in vivo bone growth through the scaffold interior are recommended to increase implant stability in the early stages of osseointegration.

3D bioactive coatings with a new type of porous ridge/cavity structure

In this study, biocompatibility of plasma-sprayed 3D CP Ti-coated wire implants has been evaluated. Plasma-sprayed 3D CP Ti coatings have a porous structure consisting of ridges and cavities whose height is equal to that of the thickness of the coating. The porosity of plasma-sprayed 3D CP Ti coatings was found to be higher in cavities and it made up 46%. To study the clinical success of these implants, post-mortem computed tomography (CT) of distal femurs of animals (mainly dogs) was carried out. In vivo studies failed to demonstrate an increase in the amount of new bone tissue around uncoated implants. The amount of new bone tissue around implants with additional ceramic coatings made up 60% after 8 weeks. The amount of new bone tissue around 3D CP Ti-coated implants was only 5% after 8 weeks; however, after 16 weeks, an intensive growth of bone tissue around implants was observed. The amount of new bone tissue around implants with an additional ceramic coating was insufficient after 16 weeks. Forty-eight weeks after implant placement, the distribution of bone tissue in 3D CP Ti, 3D CP Ti-HA- and 3D CP Ti-HA-CaP-coated implants was 74.5%, 89.2% and 92.5%, respectively. The amount of bone tissue around uncoated implants did not exceed 10%. 3D CP Ti-HA coatings demonstrated better osseointegration compared with 3D CP Ti coatings and were found to have higher shear strength (9.8 ± 1.54 MPa) at early stages of osseointegration.

The Influence of Nanostructured Hydroxyapatite Surface in the Early Stages of Osseointegration: A Multiparameter Animal Study in Low-Density Bone.

Background and ObjectiveThe success rates of dental implants in low-density bone have been reported as a challenge, especially for early or immediate loading in the maxilla posterior area. Nanoscale architecture affects the roughness, surface area, surface energy of the implant and can enhance osseointegration. This study aimed to evaluate the implant-surface topography and biomechanical, histomorphometric, and histological bone responses to a new nanostructured hydroxyapatite surface placed in the iliac crest of sheep.MethodsTen female sheep (2–4 years) received 30 implants (n=10/group): HAnano® coated (Epikut Plus®, S.I.N. Implant System, Sao Paulo, SP, Brazil), SLActive (BLX®, Straumann, Basel, Switzerland), and TiUnite (NobelActive®, Nobel Biocare, Göteborg, Sweden) surfaces. Scanning electron microscopy with energy-dispersive spectroscopy evaluated the implant surface topography, the insertion torque value, and resonance frequency analysis evaluated the primary stability, bone-implant contact, and bone-area fraction occupancy were evaluated after 14 and 28 days after implant placement.ResultsThe surface morphology was considerably comparable between the implant groups’; however, the TiUnite® group presented a remarkable different surface. The SLActive® and TiUnite® groups presented an insertion torque average of 74 (±8.9) N/cm that was similar to that of HAnano® 72 (±8.3) N/cm (p >0.05). The resonance frequency evaluated with Osstell®/SmartPeg® or Penguin®/MulTipeg® showed similar results when assessing implants from the same group. BIC and BAFO significantly increased (p<0.05) throughout the experimental periods to all groups, but BIC and BAFO values were similar among the implants at the same time point. After 4 weeks, bone-implant contact was higher than 80% of the total length analyzed. New bone occupies around 60% of analyzed area around the implants.ConclusionHAnano® coated surface promoted comparable osseointegration as SLActive and TiUnite in the sheep model. The three tested surfaces showed comparable osseointegration at the early stages of low-density bone repair in the sheep model.

Influence of nano-hydroxyapatite coating implants on gene expression of osteogenic markers and micro-CT parameters. An in vivo study in diabetic rats.

This study evaluated the response of a nano-hydroxyapatite coating implant through gene expression analysis (runt-related transcription factor 2 (Runx2), alkaline phosphatase (Alp), osteopontin (Opn), osteocalcin (Oc), receptor activator of nuclear factor-kappa B (Rank), receptor activator of nuclear factor-kappa B ligand (Rank-L), and osteoprotegerin (Opg)). Three-dimensional evaluation (percent bone volume (BV/TV); percent intersection surface (BIC); bone surface/volume ratio (BS/BV); and total porosity (To.Po)) were also analyzed. Mini implants were surgically placed in tibias of both healthy and diabetic rats. The animals were euthanized at 7 and 30 days. Evaluating all factors the relative expression of Rank showed that NANO surface presented the best results at 7 days (diabetic rats). Furthermore the levels of Runx2, Alp, Oc, and Opn suggest an increase in osteoblasts proliferation, especially in early stages of osseointegration. %BIC in healthy and diabetic (7 days) depicted statistically significant differences for NANO group. BV/TV, BS/BV and To.Po demonstrated higher values for NANO group in all evaluated time point and irrespective of systemic condition, but BS/BV 30 days (healthy rat) and 7 and 30 days (diabetic rat). Microtomographic and gene expression analyses have shown the benefits of nano-hydroxyapatite coated implants in promoting new bone formation in diabetic rats.

Influence of low-level laser therapy on implant stability in implants placed in fresh extraction sockets: A randomized clinical trial.

Low-level laser therapy (LLLT) has been suggested to improve primary stability at the early stages of osseointegration in animal models. However, there is still scarce evidence about its influence on implant stability in humans. To assess the influence of LLLT on implant stability in implants placed in fresh extraction sockets. A randomized controlled trial was designed according to the SPIRIT guidelines and is reported following the CONSORT. Patients were randomly allocated according to control or LLLT groups. LLLT consisted in the application of GaAlAs laser (808 nm, avg. power density: 50 mW, circular spot diameter and area: 0.71 cm/0.4cm2 ) applied in six points in contact mode with peri-implant soft tissue (1.23 minutes in each point of application; dose per point 11 J) before bone perforation and after suturing. The total dose resulted in 66 J per application moment. This LLLT protocol was applied only in the dental implant placement session. Implant stability was by ISQ at implant placement (T0 ) and the abutment selection (Ta ). Digital radiographs for T0 and Ta were used to assess the distance between the implant platform and alveolar bone crest, in millimeters. T-test and Shapiro-Wilk test were used to analyze data between groups using the implant as a unit of analysis. Fifty implants were placed in 44 patients. The insertion torque ranged from 15 to 60 N.cm (mean 35.64 ± 13.34). Two implants of the LLLT and one of the control groups were lost to follow-up and one implant of the control group failed to osseointegrate (4.3%). ISQ at T0 ranged from 17 to 79 (mean 59.33 ± 13.05) and from 40 to 89 (mean 66.46 SD ± 11.56) at Ta . No differences were observed when comparing the groups with ISQ difference (P = .433) or radiographical peri-implant alterations (P = .261). LLLT did not influence implant stability in implants placed in fresh extraction sockets when assessed at healing abutment installation.

Nanoporous tantalum coated zirconia implant improves osseointegration

Zirconia has become a new dental implant material because of its excellent esthetics, biocompatibility, and minimal ion release. However, biological inertness of zirconia surface results in weak integration with bone tissue in the early stage of osseointegration. To enhance the early osseointegration of zirconia implant, a homogeneous nanoporous tantalum (TaNS) coating (~30 nm in diameter and 1 μm in length) with good adhesion strength was prepared on zirconia surface via magnetron sputtering combined with anodization. The roughness and hydrophilicity in ZrO2/TaNS groups were significantly improved as compared to other groups. The protein adsorption, initial adhesion, spreading and proliferation of MC3T3-E1 cells were significantly enhanced in ZrO2/TaNS group as compared to ZrO2 and ZrO2/Ta group. Moreover, the osteogenic differentiation of MC3T3-E1 cells was significantly improved in ZrO2/TaNS groups than other groups by up-regulating the expression of the osteogenic-related genes (RunX2, ALP, COL-1, OSX, OCN and OPG). Histological analysis displayed that more newly regenerated bone was deposited around ZrO2/TaNS group than other groups, and the bone-implant contact in ZrO2/TaNS group was enhanced correspondingly. In conclusion, the TaNS coating with good adhesion strength can be successfully prepared on zirconia surface by magnetron sputtering combined with anodization. This novel coating will be a promising clinical application in improving osseointegration of the zirconia implant.

Positive modulation of osteogenesis on a titanium oxide surface incorporating strontium oxide: An in vitro and in vivo study

Surface chemistry and topography can determinatively affect the osseointegration of dental implants. Strontium (Sr) has a significant effect on the promotion of bone formation and inhibitation of bone resorption. The emphasis of this study lies on the evaluation of a new surface treatment that aims to improve the early osseointegration of dental implantation both in vitro and in vivo. A hydrothermal method was used to prepare an SrTiO3 incorporation on sandblasted large-grit double acid-etched (SLA) titanium surfaces in SrCl2 solution. The composition and morphology of the SrTiO3 doped surface were analyzed by X-ray diffraction, X-ray photoelectron spectroscopy，and scanning electron microscopy. In addition, the external release figure of Sr was examined by inductively coupled plasma mass spectrometry. The proliferation, adhesion and differentiation of MC3T3-E1 cells on this surface were evaluated in vitro and presented a significant increase in SLA-Sr group compared with that in SLA group. An in vivo study in 24 New Zealand rabbits indicated a remarkable growth in the volume of direct bone-to-implant contact and peri-implant bone in SLA-Sr group, which were compared with SLA group after 3 and 6 weeks, and removal torque tests exhibited a higher torque removal value of SLA-Sr implants. The study gave the result that the biological effect of SLA-Sr implants was significantly superior to that of the SLA implants at the early stage of osseointegration.

In vivo studies of titanium implant surface treatment by sandblasted, acid-etched and further anchored with ceramic of tetracalcium phosphate on osseointegration

The objective was to investigate and compare the osseointegrative responses of sandblasted/acid-etched (SLA) and calcium phosphate (CaP) implants in vivo. The CaP implant was prepared by control group of SLA surface modification and anchoring with sintering ceramic of tetracalcium phosphate (TTCP) to form a mechanical interlocking film. Customized screw Ti implants (size O 2.0 mm × 6 mm length) were utilized to histologically examine the bone-to-implant contact (BIC) after implantation. The implant stability quotient scales in the postoperative implants within femurs were recorded. Subsequently, the postoperative implants were scanned using microcomputed tomography (micro-CT), and the topography was examined microscopically to analyze the BIC conditions. The SLA and CaP implant groups showed increased bone mineral density (g/cm3) and BIC (%). Compared with the SLA implant, the CaP implant with TTCP improved the early osteointegration of the BIC at 1-month post-operation and demonstrated quantitative effects on the BIC at 1-month post-operation. SLA and CaP implants all showed good osseointegration through micro-CT analysis (1–6 months). The current findings suggest the CaP anchoring Ti surface demonstrated improvement in early stages of osseointegration and thus shows the potential clinical benefits of TTCP anchoring on Ti surfaces in bone-level solutions.

Interaction between Implant Surface Topography and Cells Surrounding the Implant at the Early Stage of Osseointegration

<b>Interaction between Implant Surface Topography and Cells Surrounding the Implant at the Early Stage of Osseointegration</b>

Protein expression during early stages of bone regeneration under hydrophobic and hydrophilic titanium domes. A pilot study.

There is significant evidence that, during the early stages of osseointegration, moderately rough hydrophilic (SLActive) surfaces can accelerate osteogenesis and increase bone-to-implant contact in comparison to hydrophobic (SLA) surfaces. However, very little is known regarding the molecular mechanisms behind the influence that surface chemistry modifications to increase hydrophilicity determine on bone healing. The aim of this study was to describe for the first time the proteins and related signalling pathways expressed during early osseous healing stages under SLA and SLActive titanium domes for guided bone regeneration. One SLA and 1 SLActive dome with an internal diameter of 5.0mm and a height of 3.0mm were secured to the parietal bones of nine 6-month-old male New Zealand rabbits. Three animals were randomly euthanized at 4, 7 and 14days and the newly formed tissues retrieved under the domes were analysed with liquid chromatography-mass spectrometry/mass spectrometry. STRING and KEGG databases were applied for Gene Ontology and pathway analyses. A different modulation of several pathways was detected between the 2 groups at all healing times. The main differences in the osseous healing response associated to the 2 surfaces were related to pathways involved in regulating the inflammatory response, differentiation of osteoblast precursors and skeletogenesis. At day 7, the highest number of proteins and the highest cellular activity were observed in both groups, although a more complex and articulated proteome in terms of cellular metabolism and signal transduction was observed in SLActive samples. This is the first study describing the proteome expressed during early healing stages of guided bone regeneration and osseointegration. A combination of enhanced early osteogenic response and reduced inflammatory response were suggested for the hydrophilic group. Future studies are needed to corroborate these findings and explore the molecular effects of different titanium surfaces on the cascade of events taking place during bone formation.

The influence of direct laser metal sintering implants on the early stages of osseointegration in diabetic mini-pigs.

BackgroundHigh failure rates of oral implants have been reported in diabetic patients due to the disruption of osseointegration. The aim of this study was to investigate whether direct laser metal sintering (DLMS) could improve osseointegration in diabetic animal models.MethodsSurface characterizations were carried out on two types of implants. Cell morphology and the osteogenic-related gene expression of MG63 cells were observed under conditions of DLMS and microarc oxidation (MAO). A diabetes model in mini-pigs was established by intravenous injection of streptozotocin (150 mg/kg), and a total of 36 implants were inserted into the mandibular region. Micro-computed tomography (micro-CT) and histologic evaluations were performed 3 and 6 months after implantation.ResultsThe Ra (the average of the absolute height of all points) of MAO surface was 2.3±0.3 µm while the DLMS surface showed the Ra of 27.4±1.1 µm. The cells on DLMS implants spread out more podia than those on MAO implants through cell morphology analysis. Osteogenic-related gene expression was also dramatically increased in the DLMS group. Obvious improvement was observed in the micro-CT and Van Gieson staining analyses of DLMS implants compared with MAO at 3 months, although this difference disappeared by 6 months. DLMS implants showed a higher bone–implant contact percentage (33.2%±11.2%) at 3 months compared with MAO group (18.9%±7.3%) while similar results were showed at 6 months between DLMS group (42.8%±10.1%) and MAO group (38.3%±10.8%).ConclusionThe three-dimensional environment of implant surfaces with highly porous and fully interconnected channel and pore architectures can improve cell spreading and accelerate the progress of osseointegration in diabetic mini-pigs.

Cortical and Trabecular Bone Healing Patterns and Quantification for Three Different Dental Implant Systems.

The present study hypothesized that different bone healing patterns through initial stages of osseointegration would be observed when three distinct commercially available implant systems (Nobel Groovy, Implacil, and Zimmer TSV) were used, leading to significant variations in histometric levels of total bone and new bone formation during the osseointegration process. A total of 48 implants were placed bilaterally on the tibias of eight beagle dogs and allowed to heal for 2 and 6 weeks. Following euthanasia, nondecalcified specimens were processed for morphologic and histometric evaluation. Bone-to-implant contact (BIC) and new bone area fraction occupancy (BAFO) analyses for native and new bone were performed along the whole perimeter of each implant and separately for the cortical and trabecular bone regions. Morphologic evaluation of cortical bone presented different healing patterns and osseointegration levels for different implant systems as time elapsed in vivo. Interfacial remodeling was the chief healing pattern in Zimmer implants, while a combination of interfacial remodeling and healing chambers was observed in Nobel and Implacil implants. When trabecular bone was evaluated, similar bone healing patterns were observed between systems despite different levels of osseointegration observed as a function of implantation time, implant system, and native and/or new bone BIC and BAFO. Different implant systems led to different healing patterns during early stages of osseointegration. Such variation in pattern was more noticeable in the cortical regions compared to the trabecular regions. The variation in bone healing pattern did significantly influence overall indicators of native and new BIC and BAFO during the osseointegration process. The postulated hypothesis was accepted.