Pure Titanium Implants Research Articles

Effectiveness of Implant Surface Decontamination Using a High-Pressure Sodium Bicarbonate Protocol

To evaluate the effectiveness of a high-pressure sodium bicarbonate spray protocol to decontaminate implant surfaces intentionally inoculated with bacteria. Twenty commercially pure titanium implants, 10 with machined surfaces and 10 with rough surfaces, were inoculated with Streptococcus sanguis and then submitted to a decontamination protocol using a high-pressure sodium bicarbonate spray device for 1 minute under aseptic conditions. After the application of the decontamination protocol, all bacterial cells were removed from the tested implants, regardless of surface roughness. The results suggest that regardless of the implant surface roughness, the protocol using high-pressure sodium bicarbonate spray for 1 minute, under aseptic conditions, was effective in removing all the viable bacterial cells.

Crestal remodelling and osseointegration at surface‐modified commercially pure titanium and titanium alloy implants in a canine model

Ti-6Al-7Nb alloys exhibit enhanced mechanical properties and corrosion resistance and may represent an improvement to present commercially pure (CP) titanium oral implant technology. To evaluate crestal remodelling and osseointegration at CP titanium compared with Ti-6Al-7Nb alloy oral implants using a canine model. Two threaded anodized CP titanium and two Ti-6Al-7Nb alloy anodized oral implants (ø4.5 × 6.1 mm) were placed into each jaw quadrant in the edentulated posterior mandible in six adult male Hound Labrador mongrel dogs. Abutments were placed onto the implants, and the mucogingival flaps were adapted and sutured for transmucosal wound healing. Block biopsies were collected for histometric analysis following an 8-week healing interval. Healing was uneventful. Bone density outside and within the root of the threads averaged (± SE) 49.0 ± 4.5% and 38.7 ± 5.1% for CP titanium implants and 43.2 ± 3.6% and 34.2 ± 4.8% for Ti-6Al-7Nb alloy implants. Mean osseointegration reached 68.0 ± 4.4% and 62.8 ± 2.5% for CP titanium and Ti-6Al-7Nb alloy implants, respectively. Although crestal resorption at lingual sites averaged 0.2 ± 0.1 mm for both technologies, crestal resorption at buccal sites averaged 0.9 ± 0.2 and 1.0 ± 0.6 mm for CP titanium and Ti-6Al-7Nb alloy implants, respectively. There were no statistically significant differences between implant technologies for any parameter assessed. Notably, advanced/advancing buccal crestal resorption exposing the implant threads was observed in 50% of the implants (four of six animals) regardless of implant technology; osteoclastic resorption still observed at 8 weeks following implant placement. Within the limitations of study, anodized Ti-6Al-7Nb alloy implants may represent a feasible alternative to benchmark anodized CP titanium implants. Remodelling of the buccal crestal plate resulting in advanced bone loss appears a major impediment to oral implant osseointegration and possibly, in extension, implant maintenance.

Commercially pure titanium implants with surfaces modified by laser beam with and without chemical deposition of apatite. Biomechanical and topographical analysis in rabbits

The purpose of this study was to evaluate the surfaces of commercially pure titanium (cp Ti) implants modified by laser beam (LS), without and with hydroxyapatite deposition by the biomimetic method (HAB), without (HAB) and with thermal treatment (HABT), and compare them with implants with surfaces modified by acid treatment (AS) and with machined surfaces (MS), employing topographical and biomechanics analysis. Forty-five rabbits received 75 implants. After 30, 60, and 90days, the implants were removed by reverse torque and the surfaces were topographically analyzed. At 30days, statistically significant difference (P<0.05) was observed among all the surfaces and the MS, between HAB/HABT and AS and between HAB and LS. At 60days, the reverse torque of LS, HAB, HABT, and AS differed significantly from MS. At 90days, difference was observed between HAB and MS. The microtopographic analysis revealed statistical difference between the roughness of LS, HAB, and HABT when compared with AS and MS. It was concluded that the implants LS, HAB, and HABT presented physicochemical and topographical properties superior to those of AS and MS and favored the osseointegration process in the shorter periods. In addition, HAB showed the best results when compared with other surfaces.

Monitoring Failure Rates of Commercial Implant Brands; Substantial Equivalence in Question?

The aim of this study was to report on the failure rates of two distinct dental implant systems in a clinical practice setting. Date of implant placement and loss were entered prospectively in a data registry system. Failure rates of two commercially pure titanium implants, one with a porous oxydized surface (POS) and the other with a chemically altered surface (CAS), were assessed using a quality control chart and survival analyses. A total of 860 POS and 759 CAS implants were placed. A warning of an increased failure rate of the CAS implant was identified by means of the quality control chart. Survival analyses indicated that the CAS implant failure rate was twice that of the POS implant (Hazard Ratio: 2.08; 95% CI: 1.33-3.28, P-value<0.0012). After adjusting for alternative explanations, the CAS implant remained associated with a 95% increased failure rate (95% CI: 1.14-3.35; P-value=0.0146). Abandoning the CAS implant and returning to a POS implant was associated with a non-significant 64% drop in the implant failure rate within less than a year (HR: 0.36; 95% CI: 0.12-1.14; P-value<0.0826). The difference between a 4% failure rate with the POS implant and an 8% failure with the CAS implant appears inconsistent with the assumption of substantial equivalence.

Effects of magnesium‐substituted nanohydroxyapatite coating on implant osseointegration

The objective of this study was to compare magnesium-substituted and pure hydroxyapatite coatings on the promotion of osteogenesis in vitro and on the osseointegration in vivo. Electrochemically deposited pure hydroxyapatite (EDHA) or electrochemically deposited magnesium-substituted hydroxyapatite (EDMHA) coatings were formed on the surface of pure titanium disks or implants. MC3T3-E1 preosteoblasts were cultured in the EDHA and EDMHA coated disks, and cell growth, alkaline phosphatase (ALP) activity, and osteocalcin secretion were measured at various time points. For studies on osseointegration, 30 roughened implants coated either with EDHA or EDMHA (n = 15 for each coating) were implanted in the femurs of 15 NZW rabbits. After 2, 4, and 8 weeks, femurs were retrieved and prepared for histomorphometric evaluation (n = 5 for each coating at each time point). MC3T3-E1 cells cultured on EDMHA coated disks showed increased cell number, ALP, and osteocalcin secretion compared with the EDHA coated disks at all time points (P < 0.05 for all). Histologic observation of the coated implants showed woven bone in direct contact with both implant surfaces after 2 weeks and mature bone after 8 weeks. While there were no differences in the amount of bone between the threads at any time point, the percentage of implant in direct contact with bone (bone implant contact) was slightly higher along the EDMHA coated implants at 2 weeks (P = 0.086), although this difference was no longer seen at 4 and 8 weeks. Mg-substituted HA coated surfaces promote osteogenic differentiation of preosteoblasts in vitro and may improve implant osseointegration during the early stages of bone healing compared with pure EDHA coated surfaces.

Serum bone formation marker correlation with improved osseointegration in osteoporotic rats treated with simvastatin

Simvastatin has been shown to enhance osseointegration of pure titanium implants in osteoporotic rats. This study aimed to evaluate the relationship between the serum level of bone formation markers and the osseointegration of pure titanium implants in osteoporotic rats treated with simvastatin. Fifty-four female Sprague-Dawley rats, aged 3months, were randomly divided into three groups: Sham-operated group (SHAM; n=18), ovariectomized group (OVX; n=18), and ovariectomized with simvastatin treatment group (OVX+SIM; n=18). Fifty-six days after ovariectomy, screw-shaped titanium implants were inserted into the tibiae. Simvastatin was administered orally at 5mg/kg each day after the placement of the implant in the OVX+SIM group. The animals were killed at either 28 or 84days after implantation and the undecalcified tissue sections were processed for histological analysis. Total alkaline phosphatase (ALP), bone-specific alkaline phosphatase (BALP) and bone Gla protein (BGP) were measured in all animal sera collected at the time of euthanasia and correlated with the histological assessment of osseointegration. The level of ALP in the OVX group was higher than the SHAM group at day 28, with no differences between the three groups at day 84. The level of BALP in the OVX+SIM group was significantly higher than both OVX and SHAM groups at days 28. Compared with day 28, the BALP level of all three groups showed a significant decrease at day 84. There were no significant differences in BGP levels between the three groups at day 28, but at day 84, the OVX+ SIM group showed significantly higher levels than both the OVX and SHAM groups. There was a significant increase in BGP levels between days 28 and 84 in the OVX+SIM group. The serum bone marker levels correlated with the histological assessment showing reduced osseointegration in the OVX compared to the SHAM group which is subsequently reversed in the OVX+SIM group. The results from this study indicate that the serum level of bone formation markers, especially BALP and BGP, could be correlated with the degree of osseointegration around titanium implants in osteoporotic rats treated with simvastatin.

Physicochemical state of the nanotopographic surface of commercially pure titanium following anodization-hydrothermal treatment reveals significantly improved hydrophilicity and surface energy profiles

A method of coating commercially pure titanium (cpTi) implants with a highly crystalline, thin hydroxyapatite (HA) layer using discharge anodic oxidation followed by hydrothermal treatment (Spark discharged Anodic oxidation treatment ; SA-treated cpTi) has been reported for use in clinical dentistry. We hypothesized that a thin HA layer with high crystallinity and nanostructured anodic titanium oxide film on such SA-treated cpTi implant surfaces might be a crucial function of their surface-specific potential energy. To test this, we analyzed anodic oxide (AO) cpTi and SA-treated cpTi disks by SEM and AFM. Contact angles and surface free energy of each disk surface was measured using FAMAS software. High-magnification SEM and AFM revealed the nanotopographic structure of the anodic titanium oxide film on SA-treated cpTi; however, this was not observed on the AO cpTi surface. The contact angle and surface free energy measurements were also significantly different between AO cpTi and SA-treated cpTi surfaces (Tukey's, P < 0.05). These data indicated that the change of physicochemical properties of an anodic titanium oxide film with HA crystals on an SA-treated cpTi surface may play a key role in the phenomenon of osteoconduction during the process of osseointegration.

Ex Vivo Examination of the Biocompatibility of Biodegradable Magnesium via Microdialysis in the Isolated Perfused Bovine Udder Model

Being biodegradable, magnesium is considered a promising future implant material but very little is known about the biocompatibility for the tissues in direct contact with it. In this study, the degradation of pure magnesium implants in the skin of an isolated bovine udder was examined over a period of five hours. Microdialysis technique was used in order to investigate the reactions at the interface of implant and tissue. Pure titanium implants served as control. Degradation behavior and biocompatibility were evaluated via extracellular magnesium ion concentration and PGE2 and TNF alpha served as indicators of inflammation. Concentrations of 5.5 mmol/l Mg2+ were detected at the beginning, which decreased to a plateau of about 3.5 mmol/l after approximately two and a half hours. PGE2 and TNF alpha concentrations indicated no major inflammatory tissue response to the degradation. These results give an idea of the ion burden at the implantation site of degrading magnesium and suggest good biocompatibility even at the tissue-implant interface.

Importance of Ca2+ Modifications for Osseointegration of Smooth and Moderately Rough Anodized Titanium Implants – A Removal Torque and Histological Evaluation in Rabbit

Incorporation of Ca(2+) into the titania of anodized titanium surfaces has been found to enhance osseointegration. It provides a stable surface when the ions are incorporated into the oxide layer during the anodizing process. The Ca(2+) may suggestively be prominent sites for mineral induction, attract proteins, and catalyze intracellular cascades. The aim of the present study was to evaluate the osseointegration of smooth (S(a) < 0.5 µm) and moderately rough (S(a) 1.0-2.0 µm) commercially pure titanium implants, with and without Ca(2+) , in order to reflect on the importance of surface chemistry in relation to topography. Anodized implants with (OxCa) or without Ca(2+) (Ox), blasted implants (Bl), and blasted anodized implants, with (BlOxCa) or without Ca(2+) (BlOx), were inserted in rabbit femur and tibia. The implant surfaces were characterized using interferometry, scanning electron microscopy, and X-ray photoelectron spectroscopy prior to implant installation. Removal torque (RTQ) measurements were executed on all implants after a healing period of 12 weeks. The implants were, thereafter, removed en bloc with surrounding tissues and prepared for histological evaluations. RTQ measurements of tibial implants revealed significantly higher values for BlOxCa implants (90.7 ± 23.3 Ncm) compared to OxCa (64.6 ± 18.2 Ncm) and BlOx implants (69.7 ± 17.5 Ncm) (p = 0.029). Ca(2+) modification of smooth implants placed in the femur did not reveal any differences. Ca(2+) modification of smooth implants resulted in similar interfacial shear strength as moderately rough implants and Ca(2+) modification of moderately rough implants demonstrated the significantly strongest interfacial shear strength when placed in rabbit tibia. This possibly demonstrated surface chemistry compensating for lesser roughness.

Dental implant changes following incineration

Non-visual identification of victims utilizes DNA, fingerprint and dental comparison as primary scientific identifiers. In incidents where a victim has been incinerated, there may be loss of fingerprint detail and denaturing of DNA. Although extremely durable, tooth loss will also occur with extreme temperatures and the characteristics of recovered dental implants, if any, may be the only physical identifying data available. Currently, there are no experimental investigations to determine what changes occur to dental implants following high temperature exposure. A selection of dental implants was radiographed, utilizing purpose built apparatus to allow standard methodology. They were then heated in an INFI-TROL™ kiln to a maximum temperature of 1125 °C and the radiographic procedure repeated. Image subtraction evaluation of the radiographs was recorded using Adobe ® Photoshop ®. Both commercially pure titanium and titanium alloy dental implants survived the incineration and there was oxidation of the surface leading to minor alteration of the image. There was, however, no detectable sagging of the implants. The results of this research suggest that dental implants are still recognizable following incineration. In scenarios commonly seen by forensic odontologists, heat will destroy both teeth and conventional dental restorative materials. Implants, however, will resist these conditions and will also retain the features necessary to identify the type of implant.

Ex Vivo and In Vivo Biomechanical Test of Implant Attachment to Various Materials: Introduction of a New User-Friendly Removal Torque Equipment

The removal torque (RTQ) analysis is commonly used for biomechanical evaluation of osseointegration. The overall aim of this study was to verify results obtained with a newly developed equipment for biomechanical testing of osseointegration. Verification of the new equipment for biomechanical tests involved three experiments: Part I, comparison of RTQ between implants placed in four different types of dental synthetic plasters. Part II, comparison of RTQ between custom made, experimentally used implants to self-tapping, commercially available implants molded in the same type of dental plaster. Part III, comparison of RTQ between commercially pure titanium implants to Ti6Al4V implants placed in rabbit bone, 6 weeks after insertion. Briefly, for all experiments, the peak RTQ values and the removal process were recorded every 0.01 seconds up to 10 seconds. After the measurements, peak RTQ values were converted to shear strength. The developed equipment sensitively responded to the changes of properties related to the molding plasters, implant topographies, and materials. The monitored graphs corresponded well to the expected properties of the different implants and tested materials. The new RTQ equipment proved to be accurate and could add new knowledge in understanding the biomechanical aspects of osseointegration.

Simvastatin enhances bone formation around titanium implants in rat tibiae

Statins are cholesterol-lowering drugs that have been reported to promote bone formation. The purpose of this study was to investigate the effect of simvastatin on the enhancement of bone formation around titanium implants. Thirty-week-old female rats received pure titanium implants in both tibiae. The animals were intra-peritoneally administered 0, 0.125, 1, 5 or 10 mg kg(-1) of simvastatin daily. After 30 days, the animals were sacrificed, and specimens were prepared. The bone contact ratio of the implant, bone density in the medullary canal and percentage of cortical bone were obtained. Markers for bone turnover were also measured using sera collected at the time of euthanasia. In the medullary canal, a scanty amount of bone was observed in the 0, 0.125 and 1 mg kg(-1) groups. In contrast, in both the 5 and 10 mg kg(-1) groups, thicker bone trabeculae were abundant. Histometric observations showed that the bone contact ratio and the bone density of both groups were significantly greater than those of the other groups (anova, P < 0.01). However, no significant difference in the percentage of cortical bone was found between groups. Serum chemistry showed that statin increased bone formation markers and decreased bone resorption markers. In conclusion, although the dose equivalent to that used in human patients with hypercholesterolemia was not effective, a simvastatin dose of 5 mg kg(-1) or higher increased medullary bone formation around the titanium. In contrast, no effect of simvastatin on pre-existing cortical bone was indicated.

Superior biocompatibility and osteogenic efficacy of micro-arc oxidation-treated titanium implants in the canine mandible

The aim of this paper is to test implantation outcomes and osteogenic efficacy of plasma micro-arc oxidation (MAO)-treated titanium implants in dogs. Thirty-six pure titanium implants (18 MAO-treated, 18 untreated) were inserted into the mandibles of nine adult beagles and allowed to heal under non-weight-bearing conditions. Implant stability and interface characteristics were evaluated at 4, 8 and 12 weeks post-implantation. Methods included scanning electron microscopy, mechanical testing, histological analysis and computer-quantified tissue morphology. Osseointegration was achieved in both groups, but occurred earlier and more extensively in the MAO group. Areas of direct bone/implant contact were approximately nine times higher in the MAO group than in the control group at 12 weeks (65.85% versus 7.37%, respectively; p < 0.01). Bone-implant shear strength in the MAO group (71.4, 147.2 and 266.3 MPa at weeks 4, 8 and 12, respectively) was higher than in the control group (4.3, 7.1, and 11.8 MPa at weeks 4, 8 and 12, respectively), at all assessments (all, p < 0.01). MAO treatment of titanium implants promotes more rapid formation of new bone, and increases bone-implant shear strength compared to untreated titanium implants.

Surface Characterization of Dental Implants Coated With Hydroxyapatite by Plasma Spray and Biomimetic Process

The aim of this study was to characterize implants coated with hydroxyapatite (HA) using 2 different processes. Commercially pure titanium implants were coated with HA using a modified biomimetic process and the plasma spray process. These implants were characterized by scanning electron microscopy, Fourier-transformed infrared spectroscopy, and x-ray photoelectron spectroscopy. The plasma spray process generates a typical rough topography mainly consisting of HA. The HA coating produced by biomimetic process was partially dissolved in water and only a very thin layer of calcium titanate plus calcium phosphate and probably beta-tricalcium phosphate remained. In vitro test showed that both coatings can be considered bioactive. The modified biomimetic process seems to be a simple and low-cost alternative to coat titanium with a high potential of In vitro application.

Ultrastructural study of tissues surrounding replanted teeth and dental implants

The aim of this study was to describe the ultrastructure of the dentogingival border at replanted teeth and implants. Wistar rats (8 weeks old) were divided into groups for replantation and implantation experiments. In the former, the upper right first molars were extracted and then immediately replanted. In the latter, pure titanium implants were used. All tissues were fixed, demineralized and embedded in epoxy resin for ultrastructural observations. One week after replantation, the junctional epithelium was lost, and the oral sulcular epithelium covered the enamel surface. The amount of the epithelium increased in 2 weeks, and resembled the junctional epithelium, and the internal basal lamina and hemidesmosomes were formed in 4 weeks. One week after implantation, peri-implant epithelium was formed, and in 2 and 4 weeks, this epithelium with aggregated connective tissue cells were observed. In 8 weeks, the peri-implant epithelium receded, and aligned special cells with surrounding elongated fibroblasts and bundles of collagen fibers appeared to seal the implant interface. In replantation of the tooth, the internal basal lamina remained at the surface of the enamel of the replanted tooth, which is likely to be related to regeneration of the junctional epithelium and the attachment apparatus at the epithelium-tooth interface. Following implantation, a layer of cells with characteristics of connective tissue cells, but no junctional epithelium and attachment apparatus, was formed to seal the site of the implant.

Effects of Simvastatin on bone healing around titanium implants in osteoporotic rats

Osteoporosis is known to impair the process of implant osseointegration. The recent discovery that statins (HMG-CoA reductase inhibitors) act as bone anabolic agents suggests that statins can be used as potential agents in the treatment of osteoporosis. Therefore, we hypothesized that statins will promote osteogenesis around titanium implants in subjects with osteoporosis. Fifty-four female Sprague Dawley rats, aged 3 months old, were randomly divided into three groups: Sham-operated group (SHAM; n=18), ovariectomized group (OVX; n=18), and ovariectomized with Simvastatin treatment group (OVX+SIM; n=18). Fifty-six days after being ovariectomized (OVX), screw-shaped titanium implants were inserted into the tibiae. Simvastatin was administered orally at 5 mg/kg each day after the placement of the implant in the OVX+SIM group. The animals were sacrificed at either 28 or 84 days after implantation and the undecalcified tissue sections were obtained. Bone-to-implant contact (BIC) and bone area (BA) within the limits of implant threads were measured around the cortical (zone A) and cancellous (zone B) bone regions. Furthermore, bone density (BD) of zone B in a 500 microm wide zone lateral to the implants was also measured. There were no significant differences in BIC and BA measurements in zone A in any of the three groups at either 28 or 84 days after implantation (P>0.05). By contrast, in zone B, significant differences in the measurement of BIC, BA, and BD were observed at 28 and 84 days between all three groups. Bone healing decreased with lower BIC, BA, and BD around implant in OVX group compared with other two groups, and Simvastatin reversed the negative effect of OVX on bone healing around implants with the improvement of BIC, BA, and BD in zone B. Osteoporosis can significantly influence bone healing in the cancellous bone around titanium implants and Simvastatin was shown to significantly improve the osseointegration of pure titanium implants in osteoporotic rats.

Correlation between rate of bony ingrowth to stainless steel, pure titanium, and titanium alloy implants in vivo and formation of hydroxyapetite on their surfaces in vitro

The rate of bony ingrowth to identical metal implants made of either pure titanium (cpTi), titanium alloy (Ti-6Al-4V), or stainless steel 316L (SS) inserted to the medullar canal of the femur in rats was investigated. The kinetics of spontaneous deposition of hydroxyapatite (HA) globules on the aforementioned metals in vitro during incubation in simulated body fluid (SBF) was also studied. It was found that the rate of increased bonding strength between the cpTi implants and the host bone was the highest, whereas around the SS implants it was the slowest. At 10 days postimplant insertion, the shear strength of the cpTi implants was 2.2- and 4-fold significantly higher than for the Ti-6Al-4V and the SS implants, respectively. Spontaneous formation of the HA globules on the cpTi and Ti-6Al-4V implants that were incubated in the SBF was observed as early as 6 and 10 days after incubation in SBF, respectively, whereas on SS implants, deposition of HA was evident only after 2 weeks of in vitro incubation in SBF. It is concluded that the chemical surface characteristics and the biocompatibility of the implants probably play a key role in the process of bone growth next to them, during the formation of bone in vivo. The rate of bony ingrowth to various metal implants alloys inserted into the medullar canal of rats correlates well with the induction of apatite formation on them during incubation in vitro with SBF.

In vivo evaluation of anodic TiO2 nanotubes: An experimental study in the pig

Because of their ability to mimic the dimensions of constituent components of natural bone and the possibility to serve as a gene and drug-delivery carrier, nanotubes seem to be a promising coating for medical implants. Aim of this study was to investigate the effects of a TiO(2) nanotube structured surface on periimplant bone formation in vivo when compared with an untreated standard titanium surface. Twenty-five titanium implants covered with an ordered TiO(2) nanotube layer with an individual tube diameter of 30 nm and 25 commercially pure titanium (cp-Ti) implants were placed in the frontal skull of 25 domestic pigs. To evaluate the effects of the nanotube structured implants on the periimplant bone formation, bone-implant contact (BIC), and immunohistochemistry analysis were performed at day 3, 7, 14, 30, and 90. Evaluating immunohistochemistry, a significantly higher collagen type- I expression occurred at day 7 (p = 0.003), day 14 (p = 0.016), and day 30 (p = 0.044), for the nanostructured implants in comparison with the control group. It could be found that a nanotube structured implant surface with a diameter of 30 nm does influence bone formation and bone development by enhancing osteoblast function. SEM evaluation of the specimen surfaces revealed that the nanotube coatings do resist shearing forces that evoked by implant insertion. Because of their simple, low cost, flexible manufacturing and the possibility for the usage as drug or growth factor delivery system, nanotubes seem to be a promising method for future medical implant coatings.

Evaluations of Bone Tissue Integration to Pure and Alloyed Titanium Implants

This study was performed for comparisons of tissue integration to commercially pure (CP) and titanium-6-aluminum-4 vanadium (Ti-6-Al-4V) implants using various existing three-dimensional biomechanical and two-dimensional histomorphometrical techniques, and to monitor the loosening torque during in vivo removal torque (RTQ) test with a novel unit not used before in a pilot study in rabbits. The implants were topographically characterized and inserted in femurs and tibiae of five rabbits (in total 40 implants, 20 per group). After 16 weeks, the implant integration was biomechanically evaluated by: (1) resonance frequency test, and (2) peak RTQ test and the graph from the monitoring curve. Biopsies of the implants in situ were processed to undecalcified cut and ground sections followed by light microscopical quantifications. Shear strength calculations were performed. Significantly higher mean value of RTQ (p = .01) and shear strength tests (p = .03) were observed for the CP titanium implants compared to Ti-6-Al-4V implants. The monitoring curve from the RTQ test demonstrated no differences in the shape or form that could provide further information about the differences in the implant-to-bone attachment. The CP titanium implants showed increased RTQ and shear strength values compared to the Ti-6-Al-4V implants. The new tool of monitoring the RTQ curve could not demonstrate differences between the two materials. The exact influence of the implant materials on the surrounding tissues needs to be further investigated.

Evaluation on the movement of endosseous titanium implants under continuous orthodontic forces: an experimental study in the dog

The purpose of this study was to evaluate the movement of pure titanium implants under different continuous forces in the edentulous alveolar ridge. Four pairs of titanium implants were inserted into the right maxillary and mandibular post-extraction edentulous ridge of the experimental dog. Three different levels of continuous force (100, 200, and 500 g) were loaded onto three pairs of adjacent implant abutments using a memory Ni-Ti coil spring for up to 6 months and the remaining two implant abutments as the control group received no force. The positions of implant abutments were observed and the distances between the implants abutment at the top, middle and base levels were measured at the 0th, 2nd, 3rd, 6th and 8th month of the follow-up period. There was no significant change in the distances between adjacent abutments loaded with 100 or 200 g continuous forces throughout the entire study period. However, significantly more movement of implant abutments was noted in the 500 g pair after the 3rd month of loading when compared with the 200 or the 100 g pair (both P < 0.001). This change further increased at the 6th month (P < 0.001, 0.01, respectively). Moreover, the difference in the measurements at the top, middle and base level indicated that the two adjacent implants moved in a tipping manner in the 500 g pair after 3 and 6 months of loading. The osseointegrated implants remained stable and rigid with a pulling force of 100 and 200 g after 6 months of loading. However, when the force reached 500 g, the implants moved in an inward-tipping pattern. The results suggested that endosseous titanium implants might not necessarily be rigid anchorages under all circumstances.