Evaluation of alumina toughened zirconia implants with a sintered, moderately rough surface: An experiment in the rat.

OBJECTIVE: Alumina toughened zirconia (ATZ) is more fracture resistant than unmodified zirconia and has been shown to be a viable substrate for the growth of osteoblasts. In this study, we examined the histological and biomechanical behavior of moderately roughened ATZ implants in rat femoral bone. METHODS: Miniature implants made of ATZ with pore-building polymers sintered onto the surface and electrochemically anodized titanium (TiUnite®) were placed into the femurs of Sprague-Dawley rats. Implant surface topography was analyzed by 3D laserscan measurements and scanning electron microscopy (SEM). After a healing period of 14 and 28 days, respectively, histologic and biomechanical testing was performed. RESULTS: Under the SEM, the TiUnite® surface could be clearly distinguished from the ATZ surface, but 3D laserscan measurements indicated a moderately rough surface topography for both, TiUnite® (Sa=1.31µm) and ATZ (Sa=1.51µm). The mean mineralized bone-to-implant contact showed the highest values after 14 and 28 days for TiUnite® (58%/75%) as compared to ATZ (24%/41%). The push-in values after a healing period of 14 and 28 days, respectively, increased from 20N to 39N for TiUnite® and from 10N to 25N for ATZ. SIGNIFICANCE: Our findings suggest that the moderately roughened ATZ implant surface is well accepted by rat bone tissue. However, compared to titanium, the osseointegration-process of ATZ seems to proceed more slowly in that early phase of implant integration.

Initial osteoblast-like cell response to pure titanium and zirconia/alumina ceramics.

OBJECTIVES: Outstanding mechanical properties, resistance to scratching and high biocompatibility make zirconia/alumina ceramics interesting for dental applications. To solve the problem of the well-known low temperature degradation and to provide stable mechanical properties a novel zirconia alloy ((Y,Nb)-TZP/alumina) was developed. The aim of this study was to investigate the initial bone cell response to this new zirconia/alumina composite ceramic. METHODS: HOS cells were cultured on zirconia/alumina composite (Zc) and pure titanium (Ti) discs. Surface topography was examined by atomic force microscopy (AFM), cell morphology by scanning electron microscopy (SEM). Cell proliferation (MTS) and alkaline phosphatase activity was measured at 1, 4 and 8 days. The mRNA expression of Cycline D1, the cell cycle regulating gene, integrin beta 1, osteonectin (ON) and beta-actin were evaluated by RT-PCR analysis after 12, 24 and 48 h. RESULTS: Both substrates showed a very smooth character with R(a)-values in the range of 0.002-0.113 microm supporting a continuous cellular growth. After 8 days, cell proliferation on Zc was higher than on Ti. The mRNA expression of cyclin D1 showed similar activity after 48 h on both surfaces, ALP activity was higher on Zc after 8 days. ON expression however showed no difference between the two groups. SIGNIFICANCE: Our data demonstrate that this new zirconia composite ceramic showed at least equivalent or slightly better biological response of osteoblast-like HOS cells than pure titanium during a short-time cell culture period.

Loaded custom-made zirconia and titanium implants show similar osseointegration: an animal experiment.

BACKGROUND: Zirconia might be an alternative material to titanium for dental implant fabrication. The aim of the present study was to investigate the histological behavior (osseointegration) of loaded zirconia implants in an animal model and to compare it with the behavior of titanium implants. METHODS: Five months after extraction of the upper anterior teeth, 12 custom-made titanium implants (control group) and 12 custom-made zirconia implants (test group) were inserted in the extraction sites in six monkeys. Before insertion, the titanium implant surfaces were sandblasted with Al2O3 and subsequently acid-etched. The zirconia implants were only sandblasted. Six months following implant insertion, impressions were taken for the fabrication of single crowns. A further 3 months later, nonprecious metal crowns were inserted. Five months after insertion of the crowns, the implants with the surrounding hard and soft tissues were harvested, histologically prepared, and evaluated under the light microscope regarding the peri-implant soft tissue dimensions and mineralized bone-to-implant contact. RESULTS: No implant was lost during the investigational period. The mean height of the soft peri-implant tissue cuff was 5 mm around the titanium implants and 4.5 mm around the zirconia implants. No statistically significant differences were found in the extent of the different soft tissue compartments. The mean mineralized bone-to-implant contact after 9 months of healing and 5 months of loading amounted to 72.9% (SD: 14%) for the titanium implants and to 67.4% (SD: 17%) for the zirconia implants. There was no statistically significant difference between the different implant materials. CONCLUSION: Within the limits of this animal experiment, it can be concluded that the custom-made zirconia implants osseointegrated to the same extent as custom-made titanium control implants and show the same peri-implant soft tissue dimensions.