Mechanical micromodeling of stress-shielding at the bone-implant interphase under shear loading.

Inserting a titanium implant in the bone tissue may modify its physiological loading and therefore cause bone resorption, via a phenomenon called stress-shielding. The local stress field around the bone-implant interphase (BII) created under shear loading may be influenced by different parameters such as the bone-implant contact (BIC) ratio, the bone Young's modulus, the implant roughness and the implant material. A 2-D finite element model was developed to model the BII and evaluate the impact of the aforementioned parameters. The implant roughness was described by a sinusoidal function (height 2Δ, wavelength λ), and different values of the BIC ratio were simulated. A heterogeneous distribution of the maximum shear stress was evidenced in the periprosthetic bone tissue, with high interfacial stress for low BIC ratios and low implant roughness and underloaded regions near the roughness valleys. Both phenomena may lead to stress-shielding-related effects, which were concentrated within a distance lower than 0.8λ from the implant surface. Choosing an implant material with mechanical properties matching those of bone tissue leads to a homogenized shear stress field and could help to prevent stress-shielding effects. Finally, the equivalent shear modulus of the BII was derived to replace its complex behavior with a simpler analytical model in future studies. Schematic illustrations of the 2-D finite element model used in the present study and spatial variation of the maximal shear stress in the periprosthetic bone tissue for different implant roughness and bone-implant contact ratios.

Assessment of dental implant stability using resonance frequency analysis and quantitative ultrasound methods.

Purpose Quantitative ultrasound (QUS) and resonance frequency analyses (RFA) are promising methods to assess the stability of dental implants. The aim of this in vivo preclinical study is to compare the results obtained with these two techniques with the bone-implant contact (BIC) ratio, which is the gold standard to assess dental implant stability.Methods Twenty-two identical dental implants were inserted in the tibia and femur of 12 rabbits, which were sacrificed after different healing durations (0, 4, 8 and 13 weeks). For each implant, the ultrasonic indicator (UI) and the implant stability quotient (ISQ) were retrieved just before the animal sacrifice using the QUS and RFA techniques, respectively. Histomorphometric analyses were carried out to estimate the bone-implant contact ratio.Results UI values were found to be better correlated to BIC values (R²=0.47) compared to ISQ values (R²=0.39 for measurements in one direction and R²=0.18 for the other direction), which were shown to be dependent on the direction of measurements. Errors realized on the UI were around 3.3 times lower to the ones realized on the ISQ.Conclusions QUS provide a better estimation of dental implant stability compared to RFA. This study paves the way for the future clinical development of a medical device aiming at assessing dental implant stability in a patient-specific manner. Clinical studies should confirm these results in the future.

Multimodal characterization of the bone-implant interface using Raman spectroscopy and nanoindentation.

Titanium implants are widely used in dental and orthopedic surgeries. Osseointegration phenomena lead to direct contact between bone tissue and the implant surface. The quality of the bone-implant interface (BII), resulting from the properties of newly formed bone, determines the implant stability. This study investigates the BII properties using a dedicated in vivo implant model consisting of a coin-shaped Ti-6Al-4V implant inserted in a rabbit femur for 10 weeks. A gap created below the implant was filled with newly formed bone tissue after healing. The properties of mature and newly formed bone tissues were compared using: i) Raman spectroscopy to assess the nanoscale compositional bone properties and ii) nanoindentation to quantify microscale elastic properties in site-matched regions. The mineral-to-matrix ratio, crystallinity (mineral size and lattice order), and the collagen cross-link ratio were significantly lower in newly formed bone tissue (e.g., a mineral-to-matrix ratio of 9.3 ± 0.5 for proline 853 cm-1) compared to mature bone (15.6 ± 1). Nanoindentation measurements gave Young's modulus of 12.8 ± 1.8 GPa for newly formed bone and 15.7 ± 2.3 GPa for mature bone. This multimodal and multiscale approach leads to a better understanding of osseointegration phenomena.

Spatio-temporal evolution of hydroxyapatite crystal thickness at the bone-implant interface.

A better understanding of bone nanostructure around the bone-implant interface is essential to improve longevity of clinical implants and decrease failure risks. This study investigates the spatio-temporal evolution of mineral crystal thickness and plate orientation in newly formed bone around the surface of a metallic implant. Standardized coin-shaped titanium implants designed with a bone chamber were inserted into rabbit tibiae for 7 and 13 weeks. Scanning measurements with micro-focused small-angle X-ray scattering (SAXS) were carried out on newly formed bone close to the implant and in control mature cortical bone. Mineral crystals were thinner close to the implant (1.8 ± 0.45 nm at 7 weeks and 2.4 ± 0.57 nm at 13 weeks) than in the control mature bone tissue (2.5 ± 0.21 nm at 7 weeks and 2.8 ± 0.35 nm at 13 weeks), with increasing thickness over healing time (+30 % in 6 weeks). These results are explained by younger bone close to the implant, which matures during osseointegration. Thinner mineral crystals parallel to the implant surface within the first 100 µm indicate that the implant affects the ultrastructure of neighbouring bone , potentially due to heterogeneous interfacial stresses, and suggest a longer maturation process of bone tissue and difficulty in binding to the metal. The bone growth kinetics within the bone chamber was derived from the spatio-temporal evolution of bone tissue's nanostructure, coupled with microtomographic imaging. The findings indicate that understanding mineral crystal thickness or plate orientation can improve our knowledge of osseointegration.

Multimodal Evaluation of the Spatiotemporal Variations of Periprosthetic Bone Properties.

Titanium implants are widely used in dental and orthopedic surgeries. However, implant failures still occur because of a lack of implant stability. The biomechanical properties of bone tissue located around the implant need to be assessed to better understand the osseointegration phenomena and anticipate implant failure. The aim of this study was to explore the spatiotemporal variation of the microscopic elastic properties of newly formed bone tissue close to an implant. Eight coin-shaped Ti6Al4V implants were inserted into rabbit tibiae for 7 and 13 weeks using an in vivo model allowing the distinction between mature and newly formed bone in a standardized configuration. Nanoindentation and micro-Brillouin scattering measurements were carried out in similar locations to measure the indentation modulus and the wave velocity, from which relative variations of bone mass density were extracted. The indentation modulus, the wave velocity and mass density were found to be higher (1) in newly formed bone tissue located close to the implant surface, compared to mature cortical bone tissue, and (2) after longer healing time, consistently with an increased mineralization. Within the bone chamber, the spatial distribution of elastic properties was more heterogeneous for shorter healing durations. After 7 weeks of healing, bone tissue in the bone chamber close to the implant surface was 12.3% denser than bone tissue further away. Bone tissue close to the chamber edge was 16.8% denser than in its center. These results suggest a bone spreading pathway along tissue maturation, which is confirmed by histology and consistent with contact osteogenesis phenomena.

Biomechanical behaviours of the bone-implant interface: a review.

In recent decades, cementless implants have been widely used in clinical practice to replace missing organs, to replace damaged or missing bone tissue or to restore joint functionality. However, there remain risks of failure which may have dramatic consequences. The success of an implant depends on its stability, which is determined by the biomechanical properties of the bone-implant interface (BII). The aim of this review article is to provide more insight on the current state of the art concerning the evolution of the biomechanical properties of the BII as a function of the implant's environment. The main characteristics of the BII and the determinants of implant stability are first introduced. Then, the different mechanical methods that have been employed to derive the macroscopic properties of the BII will be described. The experimental multi-modality approaches used to determine the microscopic biomechanical properties of periprosthetic newly formed bone tissue are also reviewed. Eventually, the influence of the implant's properties, in terms of both surface properties and biomaterials, is investigated. A better understanding of the phenomena occurring at the BII will lead to (i) medical devices that help surgeons to determine an implant's stability and (ii) an improvement in the quality of implants.