J Periodontal Implant Sci.  2019 Feb;49(1):25-38. 10.5051/jpis.2019.49.1.25.

Bone healing dynamics associated with 3 implants with different surfaces: histologic and histomorphometric analyses in dogs

• Lee J
• Yoo JM
• Amara HB
• Lee YM
• Lim YJ
• Kim H
• Koo KT

• KMID: 2440175
• DOI: http://doi.org/10.5051/jpis.2019.49.1.25

Abstract

PURPOSE
This study evaluated differences in bone healing and remodeling among 3 implants with different surfaces: sandblasting and large-grit acid etching (SLA; IS-III Active®), SLA with hydroxyapatite nanocoating (IS-III Bioactive®), and SLA stored in sodium chloride solution (SLActive®).
METHODS
The mandibular second, third, and fourth premolars of 9 dogs were extracted. After 4 weeks, 9 dogs with edentulous alveolar ridges underwent surgical placement of 3 implants bilaterally and were allowed to heal for 2, 4, or 12 weeks. Histologic and histomorphometric analyses were performed on 54 stained slides based on the following parameters: vertical marginal bone loss at the buccal and lingual aspects of the implant (b-MBL and l-MBL, respectively), mineralized bone-to-implant contact (mBIC), osteoid-to-implant contact (OIC), total bone-to-implant contact (tBIC), mineralized bone area fraction occupied (mBAFO), osteoid area fraction occupied (OAFO), and total bone area fraction occupied (tBAFO) in the threads of the region of interest. Two-way analysis of variance (3 types of implant surface×3 healing time periods) and additional analyses for simple effects were performed.
RESULTS
Statistically significant differences were observed across the implant surfaces for OIC, mBIC, tBIC, OAFO, and tBAFO. Statistically significant differences were observed over time for l-MBL, mBIC, tBIC, mBAFO, and tBAFO. In addition, an interaction effect between the implant surface and the healing time period was observed for mBIC, tBIC, and mBAFO.
CONCLUSIONS
Our results suggest that implant surface wettability facilitates bone healing dynamics, which could be attributed to the improvement of early osseointegration. In addition, osteoblasts might become more activated with the use of HA-coated surface implants than with hydrophobic surface implants in the remodeling phase.

Keyword

Bone-implant interface; Bone remodeling; Cell-material interactions; Dental/endosteal implant; In vivo

MeSH Terms

Animals
Bicuspid
Bone Remodeling
Bone-Implant Interface
Dogs*
Durapatite
Miners
Osseointegration
Osteoblasts
Sodium Chloride
Wettability
Durapatite
Sodium Chloride

Figure

• 

  Figure 1 Timeline of the present study.

• 

  Figure 2 Clinical photographs from the present study. Before tooth extraction (A), after tooth extraction (B), 1 month after tooth extraction (C), horizontal incision and flap reflection (D), implant placement (E), suture with 5/0 Vicryl (F).

• 

  Figure 3 Schematics of linear measurements illustrating vertical marginal bone loss at the buccal and lingual aspects of the implants (b-MBL and l-MBL, respectively) (a, b).

• 

  Figure 4 Histomorphometric analysis in the ROI, beginning at 3 mm and ending at 6 mm below the implant shoulder (B). Areas of the osteoid (green) and mineralized bone (yellow) were defined within the thread (A). Tissue-to-implant contact within the ROI (C) was differentiated into osteoid (orange), mineralized bone (blue), and void (white). ROI: region of interest.

• 

  Figure 5 Histologic photograph of dental implants with IS-III Active, IS-III Bioactive, and SLActive surfaces at 2, 4, and 12 weeks following implant placement.

• 

  Figure 6 Histologic photograph of dental implants with IS-III Active, IS-III Bioactive, and SLActive surfaces at 2, 4, and 12 weeks following implant placement. Week 2 showed osteoid and woven bone formation within implant threads. Week 4 exhibited primary peri-implant bone mixed with woven and lamella bones. At 12 weeks, primary plexiform formation nearly ceased, and secondary remodeling was ongoing around all types of implants.

• 

  Figure 7 Bar graphs of mBIC, tBIC, and mBAFO for different implant surfaces after 2, 4, and 12 weeks of healing. Red, yellow, and green bars indicate 2, 4, and 12 weeks of healing, respectively. The X-axes represent the implant surface. (A) mBIC, (B) tBIC, and (C) mBAFO values for different implant surfaces with 2, 4, and 12 weeks of healing. mBIC: mineralized bone-to-implant contact, tBIC: total bone-to-implant contact, mBAFO: mineralized bone area fraction occupied. a,b)Statistically significant difference among 2 weeks, 4 weeks and 12 weeks of healing in each implant surface (adjusted P<0.0056).

• 

  Figure 8 Bar graphs of mBIC, tBIC, and mBAFO for 2, 4, and 12 weeks of healing with 4 different implant surfaces. Orange, blue, and purple bars indicate IS-III Active, IS-III Bioactive, and SLActive implant surfaces, respectively. The X-axes represent healing time. (A) mBIC, (B) tBIC, and (C) mBAFO values for 2, 4, and 12 weeks of healing with different implant surfaces. mBIC: mineralized bone-to-implant contact, tBIC: total bone-to-implant contact, mBAFO: mineralized bone area fraction occupied. a,b)Statistically significant difference among implant surfaces for each healing time (adjusted P<0.0056).

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