Success Rate of Mandible Implants Placed in Vascularized Fibula Bone Graft: A Systematic Review.

This systematic review addressed the implant success rate after mandible reconstruction with vascularized fibula bone graft. Therefore, preferred reporting items for systematic review and meta-analysis guidelines were used to perform the systematic review, and the search included following databases: PubMed, Lilacs, Google Scholar, Open Gray, Science Direct and Cochrane. A search of medical subject headings (MeSH) and related terms (fibula) OR (vascularized) OR (microvascularized) AND (implant) OR (rehabilitation) OR (osseointegrated) AND (mandible) OR (jaw) OR (maxillofacial), without any language or time restrictions until October 2017 was carried out. The eligible studies primarily consisted of clinical cohorts designed to evaluate the feasibility of mandible reconstruction using vascularized fibula bone grafts and implant-supported rehabilitations, with a minimum observation period of 12 months. After screening, 13 eligible cohort studies for this review were selected (3 retrospective and 10 prospective). Of 285 vascularized fibular reconstructions, only 6 failures were reported with a success rate of approximately 98% after a mean follow-up period of 40 months. In total, 910 implants were placed in vascularized fibular grafts with a success rate of 92.6% (range, 82%-100%) after 40 months. Also, similar success rates for primary (95%; range, 93%-100%) and secondary (91%; range, 83%-100%) implant surgeries have been demonstrated. Considering risk factors, implant survival in irradiated patients was usually lower (76%; range, 38%-88%) than nonirradiated patients (90%; range, 83%-94%); however, it was significantly different in only 1 study. Alcohol and tobacco use has shown no significant association with implant failure in any study. Hence, implant placement in vascularized fibula bone graft presented similar success rates relative to native mandible bone rehabilitations.

Technical Strategy of Bone Graft Augmentation in the Anterior Maxilla.

Bone graft augmentation in the anterior maxilla has a high successful rate. However, suture dehiscence and consequent bone graft exposure can compromise and fail this procedure. Therefore, this article presents a new strategy of closure technique to guarantee the bone graft augmentation. The sutures occur in muscular and mucous planes to avoid suture tension, thus decreasing complications of bone graft augmentation in the anterior maxilla.

Adipose-Derived Stem Cells Decrease Bone Morphogenetic Protein Type 2-Induced Inflammation In Vivo.

PURPOSE: Recombinant human bone morphogenetic protein type 2 (rhBMP-2) has been used to promote bone regeneration. In contrast, some reports have suggested rhBMP-2 does not provide advantages over autogenous bone grafting owing to the undesirable postoperative symptoms of this growth factor. Because the undesirable symptoms of rhBMP-2 are usually promoted by inflammation, this study evaluated the in vivo effect of human adipose-derived stem cells (ASCs) incorporated into polylactic co-glycolic acid (PLGA) scaffolds in decreasing the inflammatory response induced by a low dose of rhBMP-2. MATERIALS AND METHODS: PLGA scaffolds were characterized and loaded with rhBMP-2 1, 2.5, or 5 µg per scaffold (n = 6) and the in vitro released protein amounts were quantified at 7 hours and 1, 7, and 21 days after loading (n = 3). The muscle tissue of 6 beagles received the following treatments: PLGA, PLGA plus rhBMP-2 (2.5 µg), and PLGA plus rhBMP-2 plus ASCs (1 × 10(6) ASCs). The samples were evaluated 45 days after surgery. Statistical analyses were performed and the P value was set at .05. RESULTS: PLGA plus rhBMP-2 plus ASCs yielded the smallest number of inflammatory foci (P < .001) and giant cells (P < .001) and the largest number of angiogenesis sites (P < .001). CONCLUSIONS: Human ASCs administered in vivo into PLGA scaffolds with a low dose of rhBMP-2 decrease tissue inflammation and increase angiogenesis in muscular sites.

The Effect of Osteotomy Dimension on Implant Insertion Torque, Healing Mode, and Osseointegration Indicators: A Study in Dogs.

PURPOSE: This study investigated the effect of the osteotomy diameter for implant placement torque and its effect on the osseointegration. MATERIALS AND METHODS: Eight male beagle dogs received 48 implants (3.75 mm × 10 mm) in their right and left radius, 3 implants per side and allowed to heal for 3 weeks. Three experimental groups were evaluated. Group 1: implant with an undersized osteotomy of 3.0 mm; group 2: osteotomy of 3.25 mm, and group 3: osteotomy of 3.5 mm. The insertion torque was recorded for all implants. Histological sectioning and histometric analysis were performed evaluating bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO). RESULTS: Implants of group 1 presented statistically higher insertion torque than those of groups 2 and 3 (P < 0.01). No differences in BIC or BAFO were observed between the groups. From a morphologic standpoint, substantial deviations in healing mode were observed between groups. CONCLUSION: Based on the present methodology, the experimental alterations of surgical technic can be clinically used with no detrimental effect over the osseointegration process.

Histomorphological and Histomorphometric Analyses of Grade IV Commercially Pure Titanium and Grade V Ti-6Al-4V Titanium Alloy Implant Substrates: An In Vivo Study in Dogs.

PURPOSE: To evaluate the bone response to grade IV commercially pure titanium (G4) relative to Ti-6Al-4V (G5). MATERIALS AND METHODS: Implant surface topography was characterized by optical interferometry and scanning electron microscopy (SEM). Thirty-six implants (Signo Vinces, n = 18 per group) were installed in the radius of 18 dogs. The animals were killed at 1, 3, and 6 weeks, resulting in 6 implants per group and time in vivo for bone morphology, bone-to-implant contact (BIC), and bone area fraction occupancy (BAFO) evaluation. RESULTS: SEM depicted a more uniform topography of G4 than G5. Surfaces were statistically homogeneous for Sa, Sq, and Sdr. At 1 week, new bone formation was observed within the healing connective tissue in contact with the implant surface. At 3 weeks, new bone in direct contact with the implant surface was observed at all bone regions. At 6 weeks, the healing chambers filled with woven bone depicted an onset of replacement by lamellar bone. No significant effect of substrate was detected. Time presented an effect on BIC and BAFO (P < 0.001). CONCLUSION: Both titanium substrates were biocompatible and osseoconductive at the bone tissue level.

Osseointegration of Plateau Root Form Implants: Unique Healing Pathway Leading to Haversian-Like Long-Term Morphology.

Endosteal dental implants have been utilized as anchors for dental and orthopedic rehabilitations for decades with one of the highest treatment success rates in medicine. Such success is due to the phenomenon of osseointegration where after the implant surgical placement, bone healing results into an intimate contact between bone and implant surface. While osseointegration is an established phenomenon, the route which osseointegration occurs around endosteal implants is related to various implant design factors including surgical instrumentation and implant macro, micro, and nanometer scale geometry. In an implant system where void spaces (healing chambers) are present between the implant and bone immediately after placement, its inherent bone healing pathway results in unique opportunities to accelerate the osseointegration phenomenon at the short-term and its maintenance on the long-term through a haversian-like bone morphology and mechanical properties.

Adipose-derived stem cells incorporated into platelet-rich plasma improved bone regeneration and maturation in vivo.

BACKGROUND/AIM: Some cases of tooth loss related to dental trauma require bone-grafting procedures to improve the aesthetics before prosthetic rehabilitation or to enable the installation of dental implants. Bone regeneration is often a challenge and could be largely improved by mesenchymal stem cells therapy. However, the appropriate scaffold for these cells still a problem. This study evaluated the in vivo effect of human adipose-derived stem cells incorporated into autogenous platelet-rich plasma in bone regeneration and maturation. MATERIAL AND METHODS: Adipose-derived stem cells were isolated from lipoaspirate tissues and used at passage 4. Immunophenotyping and multilineage differentiation of cells were performed and mesenchymal stem cells characteristics confirmed. Bicortical bone defects (10 mm diameter) were created in the tibia of six beagle dogs to evaluate the effect of adipose-derived stem cells incorporated into platelet-rich plasma scaffolds, platelet-rich plasma alone, autogenous bone grafts, and clot. Samples were removed 6 weeks postsurgeries and analyzed by quantification of primary and secondary bone formation and granulation tissue. RESULTS: Adipose-derived stem cells incorporated into platelet-rich plasma scaffolds promoted the highest bone formation (primary + secondary bone) (P < 0.001), the highest bone maturation (secondary bone) (P < 0.001), and the lowest amount of granulation tissue (P < 0.001). CONCLUSIONS: Adipose-derived stem cells incorporated into platelet-rich plasma scaffolds promote more bone formation and maturation, and less granulation tissue in bone defects created in canine tibia. Therefore, platelet-rich plasma can be considered as a candidate scaffold for adipose-derived stem cells to promote bone regeneration.

Amoxicillin administrations and its influence on bone repair around osseointegrated implants.

PURPOSE: The objective of this study was to evaluate the influence of 4 different amoxicillin administration protocols on osseointegration of dental implants. MATERIALS AND METHODS: Thirty-five Wistar rats received an implant in the right tibia and were divided into 5 groups (n = 7): the control group (G1), a group that received a single dose of amoxicillin suspension (40 mg/kg) hour before surgery (G2), a group that received amoxicillin suspension 1 hour before surgery and a 10-mg/kg dose every 12 hours for 3 days (G3), a group that received amoxicillin suspension 1 hour before surgery and a 10-mg/kg dose every 12 hours for 5 days (G4), and a group that received amoxicillin suspension 1 hour before surgery and a 10-mg/kg dose every 12 hours for 7 days (G5). The animals were sacrificed by anesthesia overdose 28 days after implant placement. The samples were retrieved for bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) analyses. RESULTS: BIC analysis indicated 3 different statistical groups: G1 plus G2, G3, and G4 plus G5. There was no statistical difference between G1 and G2 or between G4 and G5. G3 presented lower values, with statistical difference for G1 plus G2 and G4 plus G5. Also, a statistical difference was found between G1 plus G2 and G4 plus G5. For BAFO evaluation, no statistical difference was found for the experimental groups. CONCLUSION: The results of this study suggest that prolonged use of amoxicillin might have a negative effect on bone formation around implants.

Buccal and lingual bone level alterations after immediate implantation of four implant surfaces: a study in dogs.

OBJECTIVES: Bone formation and maintenance around implants placed immediately after tooth extraction may be affected by implant surface treatment and compromise long-term esthetic results. This study morphometrically evaluated buccal bone loss and bone-to-implant contact (BIC) of four implant systems placed immediately after tooth extraction in a dog model. MATERIAL AND METHODS: The premolars of eight beagle dogs were bilaterally extracted with a full-thickness flap, and root-form dental implants were placed on the root extraction socket. Implants (n = 16 each) with different surface treatments were placed from sites 1 to 4 and alternated between animals to allow evaluation of the same number of implants at sites and evaluation time points. Implant surface treatments were as follows: anodized, discrete crystalline deposition, SLActive, and microblasted. The left and right side provided implants that stayed for 2 and 4 weeks, respectively. Submerged healing was allowed and bone-to-implant contact (BIC) and buccal bone loss were morphometrically measured. Linear mixed models (P < 0.05) were used to assess differences between groups, across time, and their interaction. RESULTS: Buccal bone loss was observed to approximately double between 2 and 4 weeks (P = 0.01). BIC also increased between 2 and 4 weeks, by 20-25% (P = 0.01). These changes were statistically similar for each surface. CONCLUSION: When placed immediately after tooth extraction, the evaluated histomorphometric parameters vary only with time.

Histomorphometry and bone mechanical property evolution around different implant systems at early healing stages: an experimental study in dogs.

PURPOSE: Commercial implants differ at macro-, micro-, and nanolevels, which makes it difficult to distinguish their effect on osseointegration. The aim of this study was to evaluate the early integration of 5 commercially available implants (Astra OsseoSpeed, Straumann SLA, Intra-Lock Blossom Ossean, Nobel Active, and OsseoFix) by histomorphometry and nanoindentation. MATERIALS AND METHODS: Implants were installed in the tibiae of 18 beagle dogs. Samples were retrieved at 1, 3, and 6 weeks (n = 6 for each time point) and were histologically and nanomechanically evaluated. RESULTS: The results presented that both time (P < 0.01) and implant system and time interaction (P < 0.02) significantly affected the bone-to-implant contact (BIC). At 1 week, the different groups presented statistically different outcomes. No significant changes in BIC were noted thereafter. There were no significant differences in rank elastic modulus (E) or in rank hardness (H) for time (E: P > 0.80; H: P > 0.75) or implant system (E: P > 0.90; H: P > 0.85). CONCLUSIONS: The effect of different implant designs on osseointegration was evident especially at early stages of bone healing.

Histologic and biomechanical evaluation of 2 resorbable-blasting media implant surfaces at early implantation times.

This study evaluated 3 implant surfaces in a dog model: (1) resorbable-blasting media + acid-etched (RBMa), alumina-blasting + acid-etching (AB/AE), and AB/AE + RBMa (hybrid). All of the surfaces were minimally rough, and Ca and P were present for the RBMa and hybrid surfaces. Following 2 weeks in vivo, no significant differences were observed for torque, bone-to-implant contact, and bone-area fraction occupied measurements. Newly formed woven bone was observed in proximity with all surfaces.

Biomechanical and histologic evaluation of non-washed resorbable blasting media and alumina-blasted/acid-etched surfaces.

OBJECTIVES: To compare the biomechanical fixation and histomorphometric parameters between two implant surfaces: non-washed resorbable blasting media (NWRBM) and alumina-blasted/acid-etched (AB/AE), in a dog model. MATERIAL AND METHODS: The surface topography was assessed by scanning electron microscopy, optical interferometry and chemistry by X-ray photoelectron spectroscopy (XPS). Six beagle dogs of ∼1.5 years of age were utilized and each animal received one implant of each surface per limb (distal radii sites). After a healing period of 3 weeks, the animals were euthanized and half of the implants were biomechanically tested (removal torque) and the other half was referred to nondecalcified histology processing. Histomorphometric analysis considered bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO). Following data normality check with the Kolmogorov-Smirnov test, statistical analysis was performed by paired t-tests at 95% level of significance. RESULTS: Surface roughness parameters S(a) (average surface roughness) and S(q) (mean root square of the surface) were significantly lower for the NWRBM compared with AB/AE. The XPS spectra revealed the presence of Ca and P in the NWRBM. While no significant differences were observed for both BIC and BAFO parameters (P>0.35 and P>0.11, respectively), a significantly higher level of torque was observed for the NWRBM group (P=0.01). Bone morphology was similar between groups, which presented newly formed woven bone in proximity with the implant surfaces. CONCLUSION: A significant increase in early biomechanical fixation was observed for implants presenting the NWRBM surface.

Evaluation of a nanometer roughness scale resorbable media-processed surface: a study in dogs.

OBJECTIVES: This study compared the biomechanical fixation and bone-to-implant contact (BIC) of implants with different surfaces treatment (experimental - resorbable blasting media-processed nanometer roughness scale surface, and control - dual acid-etched) in a dog model. MATERIAL AND METHODS: Surface characterization was made in six implants by means of scanning electron microscopic imaging, atomic force microscopy to evaluate roughness parameters, and X-ray photoelectron spectroscopy (XPS) for chemical assessment. The animal model comprised the bilateral placement of control (n=24) and experimental surface (n=24) implants along the proximal tibiae of six mongrel dogs, which remained in place for 2 or 4 weeks. Half of the specimens were biomechanically tested (torque), and the other half was subjected to histomorphologic/morphometric evaluation. BIC and resistance to failure measures were each evaluated as a function of time and surface treatment in a mixed model ANOVA. RESULTS: Surface texturing was significantly higher for the experimental compared with the control surface. The survey XPS spectra detected O, C, Al, and Ti at the control group, and Ca (∼0.2- 0.9%) and P (∼1.7- 4.1%) besides O, C, Al, and Ti at experimental surfaces. While no statistical difference in BIC was found between experimental and control surfaces or between 2 and 4 weeks in vivo, both longer time and use of experimental surface significantly increased resistance to failure. CONCLUSIONS: The experimental surface resulted in enhanced biomechanical fixation but comparable BIC relative to control, suggesting higher bone mechanical properties around the experimental implants.

Effect of Si addition on Ca- and P-impregnated implant surfaces with nanometer-scale roughness: an experimental study in dogs.

OBJECTIVES: To investigate the effect of Si addition on a nanometer-scale roughness Ca and P implant surfaces in a canine tibia model by biomechanical and histomorphometric evaluations. MATERIAL AND METHODS: The implant surfaces comprised a resorbable media CaP microblasted (control) and a CaP resorbable media+silica-boost microblasted (experimental) surfaces. Surfaces were characterized by scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), and optical interferometry (IFM) down to the nanometric level. The animal model involved the bilateral placement of control (n=24) and experimental surface (n=24) implants along the proximal tibiae of six dogs, remaining in vivo for 2 or 4 weeks. After euthanization, half of the specimens were torqued-to-interface failure, and the other half was subjected to histomorphologic and bone-to-implant contact (BIC) evaluation. Torque and BIC statistical evaluation was performed by the Friedman test at 95% level of significance, and comparisons between groups was performed by the Dunn test. RESULTS: IFM and SEM observations depicted comparable roughness parameters for both implant surfaces on the micrometer and nanometer scales. XPS analysis revealed similar chemical composition, except for the addition of Si on the experimental group. Torque-to-interface failure and BIC mean values showed no significant differences (P=0.25 and 0.51, respectively) at both 2- and 4-week evaluation points for experimental and control groups. Early bone healing histomorphologic events were similar between groups. CONCLUSIONS: The experimental surface resulted in not significantly different biomechanical fixation and BIC relative to control. Both surfaces were biocompatible and osseoconductive.

Histologic and biomechanical evaluation of alumina-blasted/acid-etched and resorbable blasting media surfaces.

This study evaluated the early biomechanical fixation and bone-to-implant contact (BIC) of an alumina-blasted/acid-etched (AB/AE) compared with an experimental resorbable blasting media (RBM) surface in a canine model. Higher texturization was observed for the RBM than for the AB/AE surface, and the presence of calcium and phosphorus was only observed for the RBM surface. Time in vivo and implant surface did not influence torque. For both surfaces, BIC significantly increased from 2 to 4 weeks.

Bone mineral apposition rates at early implantation times around differently prepared titanium surfaces: a study in beagle dogs.

PURPOSE: This study evaluated the bone mineral apposition rate (MAR) at the bone-implant interface region of alumina-blasted/acid-etched (AB/AE), plasma-sprayed hydroxyapatite (PSHA), and nanometric-scale bioceramic-coated surfaces at early implantation times in a dog tibia model. MATERIALS AND METHODS: Implants (n = 12 per group) with three different surfaces-AB/AE, PSHA, and a bioceramic coating in the 300- to 500-nm thickness range-were placed bilaterally along the proximal tibiae of six male beagles. Implants remained for 3 and 5 weeks in vivo. Ten and 2 days prior to euthanization, calcein green and oxytetracycline were administered for bone labeling. Following euthanization, the limbs were retrieved by sharp dissection and the implants and bone were processed nondecalcified into ~30-Μm-thick sections along the implant long axis. MAR was measured by the distance between bone labels over time at the interface region (to 0.5 mm from the implant surface) and at regions > 3 mm from the implant surface (remote site). A generalized linear mixed-effects analysis of variance model was conducted with significance levels set at .05. RESULTS: Irrespective of implant surface, the MAR at the interface region was significantly higher than the MAR at the remote site. Significant MAR differences in the interface region were observed between the different surfaces (PSHA > AB/AE > nano). CONCLUSIONS: Bone kinetics during early healing stages were influenced by implant surface modifications.

Early bone healing and biomechanical fixation of dual acid-etched and as-machined implants with healing chambers: an experimental study in dogs.

PURPOSE: To evaluate the biomechanical fixation, bone-to-implant contact (BIC), and bone morphology of screw-type root-form implants with healing chambers with as-machined or dual acid-etched (DAE) surfaces in a canine model. MATERIALS AND METHODS: The animal model included the placement of machined (n = 24) and DAE (n = 24) implants along the proximal tibiae of six mongrel dogs, which remained in place for 2 or 4 weeks. Following euthanasia, half of the specimens were subjected to biomechanical testing (torque to interface failure) and the other half were processed for histomorphologic and histomorphometric (%BIC) assessments. Statistical analyses were performed by one-way analysis of variance at the 95% confidence level and the Tukey post hoc test for multiple comparisons. RESULTS: At 4 weeks, the DAE surface presented significantly higher mean values for torque to interface failure overall. A significant increase in %BIC values occurred for both groups over time. For both groups, bone formation through the classic appositional healing pathway was observed in regions where intimate contact between the implant and the osteotomy walls occurred immediately after implantation. Where contact-free spaces existed after implantation (healing chambers), an intramembranous-like healing mode with newly formed woven bone prevailed. CONCLUSIONS: In the present short-term evaluation, no differences were observed in BIC between groups; however, an increase in biomechanical fixation was seen from 2 to 4 weeks with the DAE surface.

Effect of drilling technique on the early integration of plateau root form endosteal implants: an experimental study in dogs.

PURPOSE: This study tested the hypothesis that early integration of plateau root form endosseous implants is significantly affected by surgical drilling technique. MATERIALS AND METHODS: Sixty-four implants were bilaterally placed in the diaphysial radius of 8 beagles and remained 2 and 4 weeks in vivo. Half the implants had an alumina-blasted/acid-etched surface and the other half a surface coated with calcium phosphate. Half the implants with the 2 surface types were drilled at 50 rpm without saline irrigation and the other half were drilled at 900 rpm under abundant irrigation. After euthanasia, the implants in bone were nondecalcified and referred for histologic analysis. Bone-to-implant contact, bone area fraction occupancy, and the distance from the tip of the plateau to pristine cortical bone were measured. Statistical analyses were performed by analysis of variance at a 95% level of significance considering implant surface, time in vivo, and drilling speed as independent variables and bone-to-implant contact, bone area fraction occupancy, and distance from the tip of the plateau to pristine cortical bone as dependent variables. RESULTS: The results showed that both techniques led to implant integration and intimate contact between bone and the 2 implant surfaces. A significant increase in bone-to-implant contact and bone area fraction occupancy was observed as time elapsed at 2 and 4 weeks and for the calcium phosphate-coated implant surface compared with the alumina-blasted/acid-etched surface. CONCLUSIONS: Because the surgical drilling technique did not affect the early integration of plateau root form implants, the hypothesis was refuted.

The effect of alterations on resorbable blasting media processed implant surfaces on early bone healing: a study in rabbits.

OBJECTIVES: Etching resorbable blasting media (RM) processed implants is a common engineering procedure, but the interplay between the resulting physicochemical properties and its effects on early bone healing have not been thoroughly addressed. METHODS: Screw-root form implant surfaces were treated with 1 of 3 methods: grit (alumina) blasted/acid etching, RM, and RM + acid etching (RMAA). Surface topography (n = 3 each) was characterized by scanning electron microscopy and atomic force microscopy and chemical characterization by x-ray photoelectron spectroscopy analysis. The implants were placed at the distal femur of 16 rabbits, where 3 implants, 1 from each surface, were placed bilaterally remaining 4 and 8 weeks in vivo. After euthanization, one half of the specimens were torqued to interface failure at a rate of ∼0.196 radians/min and the other half were nondecalcified processed for histomorphology and bone-to-implant contact evaluation. RESULTS: Physicochemical characterization showed that the grit (alumina) blasted/acid-etched surface was rougher than RM and RMAA. Higher levels of calcium and phosphorous were observed for the RM surface compared with the RMAA surface. No significant differences were observed in torque and bone-to-implant contact between surfaces at 4 or 8 weeks. Histomorphologic evaluation showed woven bone formation around all surfaces at 4 weeks, and its initial replacement by lamellar bone at 8 weeks. CONCLUSIONS: Despite differences in texture/chemistry, all implant surfaces were biocompatible and osseoconductive, and led to comparable in vivo bone fixation and measurable histomorphometric parameters.

Histomorphologic and histomorphometric evaluation of various endosseous implant healing chamber configurations at early implantation times: a study in dogs.

AIM: The objective of this study was to evaluate the early healing of endosseous implants presenting various healing chamber configurations in a beagle dog mandible model. METHODS: The four premolars of 12 beagle dogs were extracted and allowed to heal for a period of 8 weeks. Implants allowing six different healing chamber configurations were placed in each dog (three per side, six configurations per dog). The animals were sacrificed after 3 and 5 weeks in vivo (n=6 per time in vivo), and the implants were non-decalcified processed to slides of approximately 30 microm thickness. Bone-to-implant contact (BIC) and bone area fraction occupied (BAFO) within the healing chamber were quantified. Statistical analysis was performed by a GLM ANOVA model at 5% significance level. RESULTS: Osseointegration and healing with woven bone filling throughout all healing chambers was observed. Replacement of woven bone by lamellar bone showing primary osteonic structures was observed at 5 weeks. BIC was significantly affected by healing chamber configuration (P<0.001) and was not affected by time in vivo (P>0.42) at 3 and 5 weeks in vivo. BAFO was not affected by healing chamber configuration (P>0.14) however significantly increased over implantation time (P<0.001). CONCLUSION: Regardless of healing chamber design and dimensions considered, healing allowed the devices osseointegration. However, healing chamber configuration significantly affected osseointegration measurable parameters such as BIC.