A stability evaluation of a novel titanium dental implant/interconnected porous hydroxyapatite complex under functional loading conditions.

The aim of this study was to evaluate the stability of implant/interconnected porous calcium hydroxyapatite complex (implant/IPCHA-complex) under functional loading. Implant/IP-CHA-complexes were placed into the mandibles of four Beagle-Labrador hybrid dogs (complex-group). On the other side, an implant was placed directly (control-group). To subject the loading, the animals were fed a hard diet throughout the loading phase of 5 months. The implant stability quotients (ISQs) and bone implant contact (BIC), and histological evaluations were performed. The ISQs of implant/IP-CHA-complex was significantly lower at placement than that of the control-implant. On the other hand, there was no significant difference between in the groups during loading. The BIC measurements, there was no significantly difference between in both groups. Histologically, newly formed bone was observed in contact with most of the implant surface in the complex-group. An IP-CHA/implant-complex would be able to achieve both bone reconstruction and implant stability under functional loading conditions.

Osseointegration aspects of placed implant in bone reconstruction with newly developed block-type interconnected porous calcium hydroxyapatite.

OBJECTIVES: The purpose of this study was to evaluate the osseointegration of dental implant in bone reconstructions with interconnected porous calcium hydroxyapatite (IP-CHA). MATERIAL AND METHODS: The IP-CHA cylinders (D; 4.3 mm, H; 10.0 mm) were placed into bone sockets in each side of the femurs of four male dogs. The IP-CHA on the right side was a 24-week sample. Twelve weeks after placement, a titanium implant was placed into a socket that was prepared in half of the placed IP-CHA cylinder on the right side. On the left side, another IP-CHA cylinder was placed as a 12-week sample. After another 12 weeks, the samples were harvested, and the bone regeneration and bone-implant contact (BIC) ratios were measured. RESULTS: New bone formation area was superior in the 24-week IP-CHA compared with the 12-week IP-CHA. BIC was not significantly different between IP-CHA and the parent sites. Osseointegration was detected around the implant in IP-CHA-reconstructed bone. CONCLUSION: Our preliminary results suggest that IP-CHA may be a suitable bone graft material for reconstructing bones that require implant placement.

Inorganic polyphosphate adsorbed onto hydroxyapatite for guided bone regeneration: an animal study.

Inorganic polyphosphate (poly(P)) is recognized as a therapeutic agent that promotes fibroblast growth factor and enhances osteogenic differentiation, and in vivo, when adsorbed onto interconnected porous calcium hydroxyapatite (IP-CHA) enhances bone regeneration. The present study focused on the effect of poly(P) adsorbed onto IP-CHA granules (Poly(P)/IP-CHA) in guided bone regeneration (GBR). Dental implants were placed into the edentulous mandibular areas of five Beagle-Labrador hybrid dogs with screw expose on the buccal side, and then bone defects were filled Poly(P)/IP-CHA (test) or IP-CHA (control). After 12 weeks, histological evaluation and histomorphometrical analysis were performed. Newly-bone formation around exposed implant screw was clearly detected in the test-group. The ratio for regenerated bone height in the test group versus the control-group was 85.6±20.2 and 62.6±23.8, respectively, with no significant difference, while, that for bone implant contact was significantly higher (67.9±11.8 and 48.8±14.1, respectively). These findings indicate that Poly(P)/IP-CHA enhances bone regeneration in GBR.

The influence of fixation in formalin on the measurement of stability of implants using resonance frequency analysis and Periotest M®: a study in a dog.

Resonance frequency analysis (RFA) and Periotest® have been widely used to evaluate measurements of the stability of implants in clinical studies and animal experiments. In animals, these measurements are often made after bone has been fixed in formalin. However, it is not yet clear how this fixation influences RFA and Periotest®, and our aim was to clarify this using the implant stability quotient (ISQ) and Periotest® value (PTV). Six titanium implants were placed, 3 into each femur, of one male dog (a beagle/labrador cross). After 2 months blocks of bone were harvested, each block containing 3 implants, and were fixed in 10% neutral formalin. Measurements were made before fixation (time 0) then at 4h, and 1, 7, 14, 21, and 28 days. ISQ values of 6 implants were evaluated 3 times on the short and long axes, as were PTV. ISQ ranged from 67.5 to 79.3 and tended to increase with time. ISQ at 7-28 days were significantly higher than that at time 0. PTV ranged from -7.7 to -7.8 and did not differ significantly among fixation times. These results suggest that fixation of bony tissue in formalin might affect ISQ, so it might be preferable to measure ISQ during the early stages of fixation.

Influence of formalin fixation on the implant stability quotient and mechanical characteristics of bone.

The implant stability quotient (ISQ) has been widely evaluated in clinical studies and animal experiments. However, accurate measurement is often difficult in animal models. In such cases, measurement of ISQ in bone is needed after formalin fixation. However, it is not yet clear how such fixation influences the measurement. The purpose of this study was to investigate the influence of formalin fixation on ISQ and the mechanical characteristics of bone. Fourteen tibias were harvested from rabbits; the samples from the left (length 60mm, control group) were soaked in saline and the samples from the right (length 60mm, fixation group) were fixed in 10% neutral-buffered formalin at 4°C for 4h. Three-point bending tests were done at 5mm/min to measure the maximum load and total absorbed energy. Twelve titanium implants (Brånemark System(®) Mk-III TiUnite, Nobel Biocare, Sweden) were placed into the edentulous molar site of the mandibles of 2 dogs and the ISQ was measured by Osstell(®) (control group) 3 months later. The implants involved in the bone block were then fixed for 4h (fixation group) and the ISQ measured. The maximum load values did not differ significantly between the control and fixation groups. Total absorbed energy was significantly higher in the control group than in the fixation group. ISQ did not differ significantly between the groups. These results suggest that formalin fixation of bone might affect some of the mechanical characteristics of bone, but not its ISQ.

Development of implant/interconnected porous hydroxyapatite complex as new concept graft material.

BACKGROUND: Dental implant has been successfully used to replace missing teeth. However, in some clinical situations, implant placement may be difficult because of a large bone defect. We designed novel complex biomaterial to simultaneously restore bone and place implant. This complex was incorporated implant into interconnected porous calcium hydroxyapatite (IP-CHA). We then tested this Implant/IP-CHA complex and evaluated its effect on subsequent bone regeneration and implant stability in vivo. METHODOLOGY/PRINCIPAL FINDINGS: A cylinder-type IP-CHA was used in this study. After forming inside of the cylinder, an implant was placed inside to fabricate the Implant/IP-CHA complex. This complex was then placed into the prepared bone socket in the femur of four beagle-Labrador hybrid dogs. As a control, implants were placed directly into the femur without any bone substrate. Bone sockets were allowed to heal for 2, 3 and 6 months and implant stability quotients (ISQ) were measured. Finally, tissue blocks containing the Implant/IP-CHA complexes were harvested. Specimens were processed for histology and stained with toluidine blue and bone implant contact (BIC) was measured. The ISQs of complex groups was 77.8±2.9 in the 6-month, 72.0±5.7 in the 3-month and 47.4±11.0 in the 2-month. There was no significant difference between the 3- or 6-month complex groups and implant control groups. In the 2-month group, connective tissue, including capillary angiogenesis, was predominant around the implants, although newly formed bone could also be observed. While, in the 3 and 6-month groups, newly formed bone could be seen in contact to most of the implant surface. The BICs of complex groups was 2.18±3.77 in the 2-month, 44.03±29.58 in the 3-month, and 51.23±8.25 in the 6-month. Significant difference was detected between the 2 and 6-month. CONCLUSIONS/SIGNIFICANCE: Within the results of this study, the IP-CHA/implant complex might be able to achieve both bone reconstruction and implant stability.

Osseointegration aspects of placed implant in bone reconstruction with newly developed block-type interconnected porous calcium hydroxyapatite

ABSTRACT Artificial bone has been employed to reconstruct bone defects. However, only few reports on implant placement after block bone grafting exist. Objectives The purpose of this study was to evaluate the osseointegration of dental implant in bone reconstructions with interconnected porous calcium hydroxyapatite (IP-CHA). Material and Methods The IP-CHA cylinders (D; 4.3 mm, H; 10.0 mm) were placed into bone sockets in each side of the femurs of four male dogs. The IP-CHA on the right side was a 24-week sample. Twelve weeks after placement, a titanium implant was placed into a socket that was prepared in half of the placed IP-CHA cylinder on the right side. On the left side, another IP-CHA cylinder was placed as a 12-week sample. After another 12 weeks, the samples were harvested, and the bone regeneration and bone-implant contact (BIC) ratios were measured. Results New bone formation area was superior in the 24-week IP-CHA compared with the 12-week IP-CHA. BIC was not significantly different between IP-CHA and the parent sites. Osseointegration was detected around the implant in IP-CHA-reconstructed bone. Conclusion Our preliminary results suggest that IP-CHA may be a suitable bone graft material for reconstructing bones that require implant placement.