Assessment of bone surrounding implants in goats: ex vivo measurements by dual X-ray absorptiometry.

The aim of the present study is to determine the possibility of measuring the bone mineral density (BMD) around implants by dual energy X-ray absorptiometry (DEXA). Therefore, the trabecular BMD was measured close to 127-600 microns and at a distance from various uncoated and Ca-P-coated implants inserted into the femoral condyle of goals. The implants were left in situ for 12 weeks. In addition, the bone-implant interface was evaluated histologically. For comparative reasons the BMD of non-implanted lateral and medial femoral condyles was also measured. The reproducibility of the measurements, expressed as a coefficient of variation, was found to be 0.44%. Moreover, the regions closest to the implants exhibited a higher BMD than all other regions, and the regions located in the medial condyle showed a higher BMD than the lateral condylar regions. Although the histological sections of the implants in the medial condyle demonstrated more bone contact with the coated than with the uncoated implants, a higher density was measured around the uncoated implants. The results regarding the non-implanted condyles indicated a higher density in the medial than in the lateral condyle. In view of these results, we conclude that BMD around dental implants depends on the location of the implant and that DEXA appears to be an excellent tool for analysing bone-implant reactions.

Evaluation of Ca-P coatings in animal experiments: importance of study design.

During the last decennium the research on oral implants has increased considerably. A lot of different implant materials and types have been tested, but differences in study design and evaluation criteria make comparison of the results difficult. The purpose of this paper is to discuss surgical, statistical, and histological methods for testing and evaluating the biocompatibility of oral implants. Many formulas are available for calculating the required group size. The paper describes how such calculations can be used for the evaluation of implants and reviews the preferred surgical techniques. The control of various external influences that can contribute to the variability in obtained data are discussed. After implantation, the implants with their surrounding tissues are retrieved and subjected to histological evaluation. Currently, because of technical limitations, light microscopical sectioning is still the preferred preparation technique. After sectioning, quantitative analysis has to be performed. The parameters that can be evaluated are described. Finally, the use and potential of the described techniques are demonstrated with two examples.

The relationship of some histologic parameters, radiographic evaluations, and Periotest measurements of oral implants: an experimental animal study.

The objective of this study was to analyze the efficacy and correlation between clinical and histologic parameters used to evaluate oral implants. After extraction of the premolars and a healing time of 4 months in 16 Dutch goats, four Brånemark implants were placed in the maxillary left and right premolar regions. After a healing time of 6 months, followed by another 4 months with the permucosal abutments, the goats were sacrificed and the jaws were block-resected. Before histologic preparation, long-cone radiographs were made and Periotest scores of the implants were recorded. Bone level measured histomorphometrically were found to be 0.85 mm more apically, compared to that measured radiologically (P = .001). Furthermore, statistically significant correlations (P > 0.2) were not found between the Periotest values of the calcium-phosphate-coated and uncoated implants for (1) the first thread in contact with bone, or (2) with the total number of threads in contact with bone. It was concluded that the radiologic data overscored the real marginal bone level around screw-shaped oral implants, and that the Periotest device is neither able to discriminate between the first thread nor between the total number of threads in contact with bone.

A histological and histomorphometrical evaluation of the application of screw-designed calciumphosphate (Ca-P)-coated implants in the cancellous maxillary bone of the goat.

Various studies already have shown that the occurrence of oral implant failure is higher in the maxilla than in the mandible. To learn whether Ca-P coatings can improve the success rate of oral implants in the maxilla, three different plasma-sprayed, Ca-P-coated, self-tapping Brånemark implants were inserted in the trabecular bone of the maxilla. Before the insertion of the implants, the two first upper premolars of 16 goats were bilaterally extracted. Four months later, each animal received four types of implants: three different Ca-P-coated types and one uncoated. After an endosseous period of 6 months, the implants were provided with permucosal abutments. Four months later the animals were killed. At the end of the experiment, it appeared that 10 of the 16 installed noncoated implants had failed while of the 48 Ca-P-coated implants, only 6 had failed. All successful implants were retrieved and prepared for histomorphometrical evaluation of the bone and gingiva response. The Ca-P-coated implants showed a significantly greater percentage of bone in contact with the implant surface compared with the uncoated implants. The length of the epithelium was not significantly different for the coated compared to the uncoated implants, but the connective tissue was significantly thicker for the noncoated implants than for the Ca-P-coated implants. Also, measurements revealed that all coatings showed reduction in thickness. On the basis of these findings, we concluded that the application of Ca-P coatings (1) improves the bone-implant reaction, although all coatings reduced in thickness, and (2) is of benefit during the healing period in less mineralized trabecular bone.

An animal study on the bone behaviour of Ca-P-coated implants: influence of implant location.

Four different implant materials were installed into the mandibular corner of goats to investigate the trabecular bone response in a mainly unloaded model. The implants were installed using a standardized technique and were left in situ for 12 weeks. One goat had to be sacrificed after surgery because of a broken rib; the other animals healed uneventfully. After sacrifice of the animals, the bone response to the uncoated and the three different Ca-P implants was evaluated histologically and histomorphometrically. Four sections of each implant were evaluated; two were located in the cortical and two in the trabecular bone. Of the 44 retrieved implants, 20 implants appeared to be installed partially in the mandibular canal, as clearly visible on the X-rays. These implants were not used in the histomorphometrical measurements. Histological evaluation showed that the trabecular and cortical bone reactions were similar; there was no significant difference in the percentage of bone contact nor in the amount of bone in contact with the implants. In conclusion this study showed that the mandibular corner is an unsatisfactory model for the installation of implants because of anatomical restrictions. Also, the experiment remained inconclusive about the influence of loading conditions on bone behaviour. Nevertheless, the histological results confirmed the bioactive properties of Ca-P coatings.

The effect of Ca-P plasma-sprayed coatings on the initial bone healing of oral implants: an experimental study in the goat.

The response of bone of low density to uncoated, fluorapatite (FA), hydroxyapatite (HA), and hydroxyapatite heat treated (HAHT) plasma-sprayed coated implants was investigated 3 and 6 months after installation. Forty-eight threaded implants of commercially pure titanium were inserted into the maxilla of twelve goats according to a split-plot design. One goat died shortly after installation of the implants, five goats were sacrificed 3 months after installation, and the other six goats 6 months after installation. Histological evaluation revealed no difference in bone reaction between the 3- and 6-month implantation periods. In addition, probably due to the wide inter- and intra-animal variability, no significant difference between the 3- and the 6-month periods could be observed in the histomorphometrical measurements performed. Further, no significant differences were found in bone reaction among the various implant materials. Finally, qualitatively it appeared that all coatings showed reduction in coating thickness and that such reductions were most pronounced for the HA coatings.

Effect of calcium phosphate (Ca-P) coatings on trabecular bone response: a histological study.

The trabecular bone response to noncoated and fluorapatite (FA), hydroxyapatite (HA), and hydroxyapatite heat-treated (HAHT) plasma-sprayed coated implants was investigated in a goat animal model. Forty-eight cylindrical implants were inserted into the trabecular bone of the lateral and medial femoral condyles of twelve goats according to a split plot design. After an implantation period of twelve weeks, the bone-implant interface was evaluated histologically. Quantitative histomorphometrical measurements demonstrated a significant difference in bone contact between implants inserted in the lateral and medial condyles. In addition, a significant difference in bone apposition was observed between the coated and the uncoated implants. Finally, all Ca-P coatings showed reduction in coating thickness. Measurements revealed that FA and HAHT showed less reduction in coating thickness than HA coating. Despite the coating reduction, the bone remained in close contact with the implant surface.