Detailed Process of Bone Remodeling After Achievement of Osseointegration in a Rat Implantation Model

Nanographene Oxide Promotes Angiogenesis by Regulating Osteoclast Differentiation and Platelet-Derived Growth Factor Secretion

An imbalanced system of angiogenesis-osteoblasts-osteoclasts is regarded as the main factor in bone remodeling dysfunction diseases or osseointegration loss. Osteoclast precursors are the key cells that accelerate bone-specific angiogenesis and maintain normal osteoblast and osteoclast function. Graphene oxide is an effective scaffold surface modification agent with broad application prospects in bone tissue engineering. However, the effect of graphene oxide on the interaction between osteoclasts and angiogenesis has not yet been elucidated. In this study, a rat calvarial defect model was established and treated with an electrochemically derived nanographene oxide (ENGO) hydrogel. Higher angiogenesis and platelet-derived growth factor (PDGF) B in preosteoclasts were observed in the ENGO group compared with that in the control group. Moreover, in vitro experiments demonstrate the efficacy of ENGO in substantially reducing the expression of the receptor activator of nuclear factor-kappaB ligand (RANKL)-induced osteoclast-associated markers and inhibiting bone resorption activity. Additionally, ENGO enhances the secretion of the osteoclast-derived coupling factor PDGF-BB and promotes angiogenesis. Our investigation revealed the crucial role of isocitrate dehydrogenase 1 (IDH1) in the ENGO-mediated regulation of osteoclast differentiation and PDGF-BB secretion. The decreased expression of IDH1 reduces the level of histone lysine demethylase 7A (KDM7A) and subsequently increases the H3K9me2 level in the cathepsin K promoter region. In summary, we found that ENGO promotes angiogenesis by inhibiting the maturity of RANKL-induced osteoclasts and enhancing PDGF-BB secretion. These results indicate that ENGO holds promise for the application in fostering osteoclast-endothelial cell crosstalk, providing an effective strategy for treating bone resorption and osteoclast-related bone loss diseases.

Monocyte Differentiation on Atomic Layer-Deposited (ALD) Hydroxyapatite Coating on Titanium Substrate

Hydroxyapatite (HA; Ca₁₀(PO₄)₆(OH)₂) coating of bone implants has many beneficial properties as it improves osseointegration and eventually becomes degraded and replaced with new bone. We prepared HA coating on a titanium substrate with atomic layer deposition (ALD) and compared monocyte differentiation and material resorption between ALD-HA and bone. After stimulation with macrophage colony-stimulating factor (M-CSF) and receptor activator of nuclear factor kappa-B ligand (RANKL), human peripheral blood monocytes differentiated into resorbing osteoclasts on bovine bone, but non-resorbing foreign body cells were observed on ALD-HA. The analysis of the topography of ALD-HA and bone showed no differences in wettability (water contact angle on ALD-HA 86.2° vs. 86.7° on the bone), but the surface roughness of ALD-HA (Ra 0.713 µm) was significantly lower compared to bone (Ra 2.30 µm). The cellular reaction observed on ALD-HA might be a consequence of the topographical properties of the coating. The absence of resorptive osteoclasts on ALD-HA might indicate inhibition of their differentiation or the need to modify the coating to induce osteoclast differentiation.

Roles of osteoclasts in alveolar bone remodeling

Osteoclasts are large multinucleated cells from hematopoietic origin and are responsible for bone resorption. A balance between osteoclastic bone resorption and osteoblastic bone formation is critical to maintain bone homeostasis. The alveolar bone, also called the alveolar process, is the part of the jawbone that holds the teeth and supports oral functions. It differs from other skeletal bones in several aspects: its embryonic cellular origin, the form of ossification, and the presence of teeth and periodontal tissues; hence, understanding the unique characteristic of the alveolar bone remodeling is important to maintain oral homeostasis. Excessive osteoclastic bone resorption is one of the prominent features of bone diseases in the jaw such as periodontitis. Therefore, inhibiting osteoclast formation and bone resorptive process has been the target of therapeutic intervention. Understanding the mechanisms of osteoclastic bone resorption is critical for the effective treatment of bone diseases in the jaw. In this review, we discuss basic principles of alveolar bone remodeling with a specific focus on the osteoclastic bone resorptive process and its unique functions in the alveolar bone. Lastly, we provide perspectives on osteoclast-targeted therapies and regenerative approaches associated with bone diseases in the jaw.

Titanium nanotopography induces osteocyte lacunar-canalicular networks to strengthen osseointegration

Osteocyte network architecture is closely associated with bone turnover. The cellular mechanosensing system regulates osteocyte dendrite formation by enhancing focal adhesion. Therefore, titanium surface nanotopography might affect osteocyte network architecture and improve the peri-implant bone tissue quality, leading to strengthened osseointegration of bone-anchored implants. We aimed to investigate the effects of titanium nanosurfaces on the development of osteocyte lacunar-canalicular networks and osseointegration of dental implants. Alkaline etching created titanium nanosurfaces with anisotropically patterned dense nanospikes, superhydrophilicity, and hydroxyl groups. MLO-Y4 mouse osteocyte-like cells cultured on titanium nanosurfaces developed neuron-like dendrites with increased focal adhesion assembly and gap junctions. Maturation was promoted in osteocytes cultured on titanium nanosurfaces compared to cells cultured on machined or acid-etched micro-roughened titanium surfaces. Osteocytes cultured in type I three-dimensional collagen gels for seven days on nano-roughened titanium surfaces displayed well-developed interconnectivity with highly developed dendrites and gap junctions compared to the poor interconnectivity observed on the other titanium surfaces. Even if superhydrophilicity and hydroxyl groups were maintained, the loss of anisotropy-patterned nanospikes reduced expression of gap junction in osteocytes cultured on alkaline-etched titanium nanosurfaces. Four weeks after placing the titanium nanosurface implants in the upper jawbone of wild-type rats, osteocytes with numerous dendrites were found directly attached to the implant surface, forming well-developed lacunar-canalicular networks around the nano-roughened titanium implants. The osseointegration strength of the nano-roughened titanium implants was significantly higher than that of the micro-roughened titanium implants. These data indicate that titanium nanosurfaces promote osteocyte lacunar-canalicular network development via nanotopographical cues and strengthen osseointegration. STATEMENT OF SIGNIFICANCE: The clinical stability of bone-anchoring implant devices is influenced by the bone quality. The osteocyte network potentially affects bone quality and is established by the three-dimensional (3D) connection of neuron-like dendrites of well-matured osteocytes within the bone matrix. No biomaterials are known to regulate formation of the osteocyte network. The present study provides the first demonstration that titanium nanosurfaces with nanospikes created by alkali-etching treatment enhance the 3D formation of osteocyte networks by promoting osteocyte dendrite formation and maturation by nanotopographic cues, leading to strengthened osseointegration of titanium implants. Osteocytes attached to the titanium nanosurfaces via numerous cellular projections. The success of osteocyte regulation by nanotechnology paves the way for development of epoch-making technologies to control bone quality.

Controlled mechanical early loads improve bone quality and quantity around implants: An in vivo experimental study

OBJECTIVES

This study aimed to investigate the effects of early loads on bone quality and quantity around implants and to compare the effects of early loads on bone quality and quantity with the effects of conventional loads.

MATERIALS AND METHODS

Grade IV-titanium implants with buttress threads were placed in rat maxillary bone 4 weeks after extraction of first molars. A controlled mechanical load (10 N, 3 Hz, 1,800 cycles, 2 days/week) was started via the implants 1 and 3 weeks after implant placement for 2 weeks (early and conventional loads, respectively). Bone quality, defined as distribution of bone cells, types and orientation of collagen fibers, and production of semaphorin3A, its receptor neuropilin-1, and sclerostin, were quantitatively evaluated.

RESULTS

Early loads substantially and positively affected bone quality by changing the preferential alignment of collagen fibers with increased production of type I and III collagens, semaphorin3A, and neuropilin-1, increased osteoblast numbers, decreased production of sclerostin, and decreased osteoclast numbers both inside and outside the implant threads, when compared with non-loaded conditions. Conventional loads changed bone quality around implants slightly. Interestingly, early loads had significantly stronger effects on bone quality and quantity based on the evaluation parameters than conventional loads.

CONCLUSIONS

This is the first report to provide scientific evidence for load initiation time based on both bone quality and quantity around implants. These new findings show that implants with buttress threads transmitted early loads optimally to bone tissue by improving bone quality and quantity inside and outside the implant threads.

Osteoblast Attachment on Titanium Coated with Hydroxyapatite by Atomic Layer Deposition

Background: The increasing demand for bone implants with improved osseointegration properties has prompted researchers to develop various coating types for metal implants. Atomic layer deposition (ALD) is a method for producing nanoscale coatings conformally on complex three-dimensional surfaces. We have prepared hydroxyapatite (HA) coating on titanium (Ti) substrate with the ALD method and analyzed the biocompatibility of this coating in terms of cell adhesion and viability. Methods: HA coatings were prepared on Ti substrates by depositing CaCO₃ films by ALD and converting them to HA by wet treatment in dilute phosphate solution. MC3T3-E1 preosteoblasts were cultured on ALD-HA, glass slides and bovine bone slices. ALD-HA and glass slides were either coated or non-coated with fibronectin. After 48h culture, cells were imaged with scanning electron microscopy (SEM) and analyzed by vinculin antibody staining for focal adhesion localization. An 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide (MTT) test was performed to study cell viability. Results: Vinculin staining revealed similar focal adhesion-like structures on ALD-HA as on glass slides and bone, albeit on ALD-HA and bone the structures were thinner compared to glass slides. This might be due to thin and broad focal adhesions on complex three-dimensional surfaces of ALD-HA and bone. The MTT test showed comparable cell viability on ALD-HA, glass slides and bone. Conclusion: ALD-HA coating was shown to be biocompatible in regard to cell adhesion and viability. This leads to new opportunities in developing improved implant coatings for better osseointegration and implant survival.

Investigation of the impact of magnesium versus titanium implants on protein composition in osteoblast by label free quantification

Metallic implant biomaterials predominate in orthopaedic surgery. Compared to titanium-based permanent implants, magnesium-based ones offer new possibilities as they possess mechanical properties closer to the ones of bones and they are biodegradable. Furthermore, magnesium is more and more considered to be "bioactive" i.e., able to elicit a specific tissue response or to strengthen the intimate contact between the implant and the osseous tissue. Indeed, several studies demonstrated the overall beneficial effect of magnesium-based materials on bone tissue (in vivo and in vitro). Here, the direct effects of titanium and magnesium on osteoblasts were measured on proteomes levels in order to highlight metal-specific and relevant proteins. Out of 2100 identified proteins, only 10 and 81 differentially regulated proteins, compare to the control, were isolated for titanium and magnesium samples, respectively. Selected ones according to their relationship to bone tissue were further discussed. Most of them were involved in extracellular matrix maturation and remodelling (two having a negative effect on mineralisation). A fine-tuned balanced between osteoblast maturation, differentiation and viability was observed.

Bone heating and implant removal using a high-frequency electrosurgical device: An in vivo experimental study

OBJECTIVES

Failed implant removal using a high-frequency electrosurgical device (HFED) has been reported to be less invasive than other surgical techniques. We sought to clarify the mechanism of removal torque reduction in an implant by heating with HFED.

MATERIALS AND METHODS

Sixty-eight Wistar rats received titanium implants on the maxillary bone 4 weeks after extraction of the first and second molars. The control group was sacrificed 6 weeks after implant installation. In the experimental group, the implant was heated by HFED for 10 s using three different power outputs, and samples were collected at 3, 7, and 14 days after heating. Removal torque measurement and histological analysis were performed in the control and experimental groups. Implant surfaces were observed using an electron-probe microanalyzer (EPMA). Data were analyzed using Mann-Whitney U test at a significance level of 5%.

RESULTS

The removal torque could not be measured in the control group due to fracture of the implant. After heating, the removal torque was measurable without fracture and decreased significantly at 14 days as compared with that at 3 days (p < .05). Heating with "min" power output resulted in a significantly smaller blank lacunae area and fewer osteoclasts at 14 days after heating (p < .05). EPMA revealed bone matrix adherence to outer surface of heated implant.

CONCLUSIONS

After heating, an enlarged area of blank lacunae around the implant and an increased number of osteoclasts into the bone marrow cavity were observed, which may have contributed to the reduction in removal torque.

Cellular and Molecular Dynamics during Early Oral Osseointegration: A Comprehensive Characterization in the Lewis Rat

OBJECTIVE

There is a need to improve the predictability of osseointegration in implant dentistry. Current literature uses a variety of in vivo titanium (Ti) implantation models to investigate failure modes and test new materials and surfaces. However, these models produce a variety of results, making comparison across studies difficult. The purpose of this study is to validate an oral osseointegration in the Lewis rat to provide a reproducible baseline to track the inflammatory response and healing of Ti implants.

METHODS

Ti screws (0.76 mm Ø × 2 mm length) were implanted into the maxillary diastema of 52 adult male Lewis rats. Peri-implant tissues were evaluated 2, 7, 14, and 30 days after implantation (n = 13). Seven of the 13 samples underwent microtomographic analysis, histology, histomorphometry, and immunohistochemistry to track healing parameters. The remaining six samples underwent quantitative polymerase chain reaction (qPCR) to evaluate gene expression of inflammation and bone remodeling markers over time.

RESULTS

This model achieved a 78.5% success rate. Successful implants had a bone to implant contact (BIC)% of 68.86 ± 3.15 at 30 days on average. Histologically, healing was similar to other rodent models: hematoma and acute inflammation at 2 days, initial bone formation at 7, advanced bone formation and remodeling at 14, and bone maturation at 30. qPCR indicated the highest expression of bone remodeling and inflammatory markers 2-7 days, before slowly declining to nonsurgery control levels at 14-30 days.

CONCLUSION

This model combines cost-effectiveness and simplicity of a rodent model, while maximizing BIC, making it an excellent candidate for evaluation of new surfaces.

Multifunctional natural polymer-based metallic implant surface modifications

High energy traumas could cause critical damage to bone, which will require permanent implants to recover while functionally integrating with the host bone. Critical sized bone defects necessitate the use of bioactive metallic implants. Because of bioinertness, various methods involving surface modifications such as surface treatments, the development of novel alloys, bioceramic/bioglass coatings, and biofunctional molecule grafting have been utilized to effectively integrate metallic implants with a living bone. However, the applications of these methods demonstrated a need for an interphase layer improving bone-making to overcome two major risk factors: aseptic loosening and peri-implantitis. To accomplish a biologically functional bridge with the host to prevent loosening, regenerative cues, osteoimmunomodulatory modifications, and electrochemically resistant layers against corrosion appeared as imperative reinforcements. In addition, interphases carrying antibacterial cargo were proven to be successful against peri-implantitis. In the literature, metallic implant coatings employing natural polymers as the main matrix were presented as bioactive interphases, enabling rapid, robust, and functional osseointegration with the host bone. However, a comprehensive review of natural polymer coatings, bridging and grafting on metallic implants, and their activities has not been reported. In this review, state-of-the-art studies on multifunctional natural polymer-based implant coatings effectively utilized as a bone tissue engineering (BTE) modality are depicted. Protein-based, polysaccharide-based coatings and their combinations to achieve better osseointegration via the formation of an extracellular matrix-like (ECM-like) interphase with gap filling and corrosion resistance abilities are discussed in detail. The hypotheses and results of these studies are examined and criticized, and the potential future prospects of multifunctional coatings are also proposed as final remarks.

Long-term stability behavior of paramedian palatal mini-implants: A repeated cross-sectional study

INTRODUCTION

The initial stability of orthodontic mini-implants is well investigated over a period of 6 weeks. There is no clinical data available dealing with the long-term stability. The aim of this study was the assessment of long-term stability of paramedian palatal mini-implants in humans.

METHODS

Stability of 20 implants was measured after removal of the orthodontic appliance (sliding mechanics for sagittal molar movement 200 cN each side) before explantation (T4) using resonance frequency analysis (RFA). Data were compared with a matched group of 21 mini-implants assessing the stability immediately after insertion, and after 2, 4, and 6 weeks (T0-T3). The mini-implants used in this study were machined self-drilling titanium implants (2.0 × 9.0 mm). Gingival thickness at the insertion site was 1-2 mm.

RESULTS

The implant stability quotient (ISQ) values before removal of the implant at T4 were 25.2 ± 2.9 after 1.7 ± 0.2 years and did not show a statistically significant change over time compared with the initial healing group (T0-T3).

CONCLUSIONS

Comparing the stability of mini-implants just after completion of the healing period and at the end of their respective usage period revealed no significant difference. An increase of secondary stability could not be detected. The level of stability seemed to be appropriate for orthodontic anchorage.

Effect of Combined Application of Growth Factors and Diode Laser Bio-Stimulation on the Osseo Integration of Dental Implants

BACKGROUND:

The success of implants is associated first with their osseointegration, and later on with their survival rate. In recent years, many efforts have been exerted to develop implant design, geometry, materials and techniques to enhance the osseointegration process and also to increase the success rate of implant procedures. New techniques, like leukocyte and platelet-rich fibrin (L-PRF) and low-level laser treatment (LLLT), have been developed to enhance the osseointegration around dental implants.

AIM:

This study aims at accelerating bone osseointegration process around dental implant using new techniques to increase the success rate, to allow immediate or early loading of a dental implant, and to make a comparison between the various new techniques in dental implant procedures to figure out which technique will achieve the best results.

METHODS:

The study was conducted on a random sample of 40 male patients. Dental implants were placed in the posterior areas of the lower jaw. Patients were divided randomly into 4 groups; control group, LLLT group, L-PRF group and L-PRF plus LLLT group. They were assessed using cone-beam computed tomography (CBCT).

RESULTS:

The results showed significant differences between all groups over different measured times. All the groups showed improvement in comparison with Normal group, where L-PRF group showed the best result followed by (L-PRF+LLLT) group, while the LLLT group showed the least improvement in comparison with bothL-PRF group and (L-PRF+LLLT) group.

CONCLUSION:

The study demonstrates that L-PRF gives a better performance in the osseointegration around dental implants than LLLT.

Development of a quantitative preclinical screening model for implant osseointegration in rat tail vertebra

Objectives

Functional tooth replacement and bone regeneration are parts of the daily practice in modern dentistry, but well-reproducible and relatively inexpensive experimental models are still missing. We aimed to develop a new small animal model to monitor osseointegration utilizing the combination of multiple evaluation protocols.

Material and methods

After cutting the tail between the C4 and C5 vertebrae in Wistar rats, costume made, parallel walled, non-threaded implants were placed into the center of the tail parallel with its longitudinal axis using a surgical guide. Osseointegration of the titanium implants was followed between 4 and 16 weeks after surgery applying axial extraction force, and resonance frequency analysis as functional tests, and histomorphometry and micro-CT as structural evaluations.

Results

In functional tests, we observed that both methods are suitable for the detection of the time-dependent increase in osseointegration, but the sensitivity of the pull-out technique (an approximately five times increase with rather low standard error) was much higher than that of the resonance frequency analysis. In structural evaluations, changes in the detected bone implant contact values measured by histomorphometry (yielding 1.5 times increase, with low variations of data) were more reliable than micro-CT based evaluations to screen the developments of contact between bone and implant.

Conclusion

Our results provide evidence that the caudal vertebrae osseointegration model is useful for the preclinical evaluation of implant integration into the bone.

Clinical relevance

The combination of the biomechanical and structural tests offers a well-reproducible small animal system that can be suitable for studying the integration of various implant materials and surface treatments.

Effects of mechanical repetitive load on bone quality around implants in rat maxillae

Greater understanding and acceptance of the new concept "bone quality", which was proposed by the National Institutes of Health and is based on bone cells and collagen fibers, are required. The novel protein Semaphorin3A (Sema3A) is associated with osteoprotection by regulating bone cells. The aims of this study were to investigate the effects of mechanical loads on Sema3A production and bone quality based on bone cells and collagen fibers around implants in rat maxillae. Grade IV-titanium threaded implants were placed at 4 weeks post-extraction in maxillary first molars. Implants received mechanical loads (10 N, 3 Hz for 1800 cycles, 2 days/week) for 5 weeks from 3 weeks post-implant placement to minimize the effects of wound healing processes by implant placement. Bone structures, bone mineral density (BMD), Sema3A production and bone quality based on bone cells and collagen fibers were analyzed using microcomputed tomography, histomorphometry, immunohistomorphometry, polarized light microscopy and birefringence measurement system inside of the first and second thread (designated as thread A and B, respectively), as mechanical stresses are concentrated and differently distributed on the first two threads from the implant neck. Mechanical load significantly increased BMD, but not bone volume around implants. Inside thread B, but not thread A, mechanical load significantly accelerated Sema3A production with increased number of osteoblasts and osteocytes, and enhanced production of both type I and III collagen. Moreover, mechanical load also significantly induced preferential alignment of collagen fibers in the lower flank of thread B. These data demonstrate that mechanical load has different effects on Sema3A production and bone quality based on bone cells and collagen fibers between the inside threads of A and B. Mechanical load-induced Sema3A production may be differentially regulated by the type of bone structure or distinct stress distribution, resulting in control of bone quality around implants in jaw bones.

Postoperative irradiation after implant placement: A pilot study for prosthetic reconstruction

PURPOSE

On maxillofacial tumor patients, oral implant placement prior to postoperative radiotherapy can shorten the period of prosthetic reconstruction. There is still lack of research on effects of post-implant radiotherapy such as healing process or loading time, which is important for prosthodontic treatment planning. Therefore, this study evaluated the effects of post-implant local irradiation on the osseointegration of implants during different healing stages.

MATERIALS AND METHODS

Custom-made implants were placed bilaterally on maxillary posterior edentulous area 4 weeks after extraction of the maxillary first molars in Forty-eight Sprague-Dawley rats. Experimental group (exp.) received radiation after implant surgery and the other group (control) didn't. Each group was divided into three sub-groups according to the healing time (2, 4, and 8 week) from implant placement. The exp. group 1, 2 received 15-Gy radiation 1 day after implant placement (immediate irradiation). The exp. group 3 received 15-Gy radiation 4 weeks after implant placement (delayed irradiation).

RESULTS

The bone mineral density (BMD) was significantly lower in the immediate irradiation groups. BMD was similar in the delayed irradiation group and the control group. The irradiated groups exhibited a lower bone-to-implant contact ratio, although the difference was not statistically significant. The irradiated groups also exhibited a significantly lower bone volume and higher empty lacuna count than the control groups. No implant failure due to local irradiation was found in this study.

CONCLUSION

Within the limits of this study, the timing of local irradiation critically influences the bone healing mechanism, which is related to loading time of prostheses.

A pre-clinical murine model of oral implant osseointegration

Many of our assumptions concerning oral implant osseointegration are extrapolated from experimental models studying skeletal tissue repair in long bones. This disconnect between clinical practice and experimental research hampers our understanding of bone formation around oral implants and how this process can be improved. We postulated that oral implant osseointegration would be fundamentally equivalent to implant osseointegration elsewhere in the body. Mice underwent implant placement in the edentulous ridge anterior to the first molar and peri-implant tissues were evaluated at various timepoints after surgery. Our hypothesis was disproven; oral implant osseointegration is substantially different from osseointegration in long bones. For example, in the maxilla peri-implant pre-osteoblasts are derived from cranial neural crest whereas in the tibia peri-implant osteoblasts are derived from mesoderm. In the maxilla, new osteoid arises from periostea of the maxillary bone but in the tibia the new osteoid arises from the marrow space. Cellular and molecular analyses indicate that osteoblast activity and mineralization proceeds from the surfaces of the native bone and osteoclastic activity is responsible for extensive remodeling of the new peri-implant bone. In addition to histologic features of implant osseointegration, molecular and cellular assays conducted in a murine model provide new insights into the sequelae of implant placement and the process by which bone is generated around implants.

Ultrastructural study by backscattered electron imaging and elemental microanalysis of bone-to-biomaterial interface and mineral degradation of porcine xenografts used in maxillary sinus floor elevation

OBJECTIVES

The aim of this study was to carry out an ultrastructural study of the biomaterial-to-bone interface and biomaterial mineral degradation in retrieved bone biopsies following maxillary sinus augmentation using collagenized porcine xenografts (Osteobiol(®) Mp3) in 15 clinical cases.

MATERIALS AND METHODS

Nine months after sinus lifting, bone cores were harvested from the maxillary sinus. The specimens were processed for observation under a scanning electron microscope with backscattered electron imaging (SEM-BSE). In addition, chemical analysis and elemental mapping of the mineral composition were generated using a microanalytical system based on energy-dispersive X-ray spectrometry (EDX).

RESULTS

No clinical complications were evident during surgery. Scanning electron microscopy revealed that newly formed bone had become closely attached to the xenograft. Statistical analysis showed a significantly high Ca/P ratio in the biomaterial (2.46 ± 0.16) and at the bone interface (2.00 ± 0.48) compared to bone (1.97 ± 0.36), which suggests that there may be a gradual diffusion of Ca ions from the biomaterial into the newly forming bone at the interface as part of the biomaterial's resorption process. EDX analysis of the residual porcine biomaterial at different points showed some particle categories with different mean ratios of Ca/P according to size, pointing to different stages of the resorption process.

CONCLUSIONS

The biomaterial proved to be biocompatible, bioreabsorbable and osteoconductive when used as a bone substitute for maxillary sinus elevation. SEM-BSE revealed that newly formed bone had become closely attached to the xenografts. EDX analysis monitored the resorption process of the porcine bone xenograft. Elemental mapping showed that there was a gradual diffusion of Ca ions from the biomaterial to the newly forming bone at the interface.

Titanium implant with nanostructured zirconia surface promotes maturation of peri-implant bone in osseointegration

The goal of the experiment outlined in this article is to improve upon noncemented methods of arthroplasty for clinical application in elderly patients. This was done by determining whether titanium implants with a novel nanostructured zirconia surface, which was created by ion beam-assisted deposition, would prevent impaired osseointegration of intramedullary implants in 1-year-old rats receiving a protein-deficient diet. Specifically, we asked whether the implant with the nanostructured zirconia surface would increase expression of markers of bone maturation within the remodeling of peri-implant woven bone. The control implants, which were made of commercially pure titanium, had a polished surface ex vivo but are known to acquire a microstructured titania surface in vivo. Ten 1-year-old rats received experimental implant (group A) and 10 had control (group B) implants. Ten 3-month-old rats received normal protein diet and the control implant (group C). Animals were euthanized 8 weeks after implantation, and transverse sections of femur-implant samples were used for histology, micro-computed tomography and immunohistochemical evaluations. In group B, the expression of α2β1 and α5β1 integrins, which are known to mediate osteoblast adhesion, glycosaminoglycans, heparan sulfate and chondroitin sulfate, was less than half of that in group C. Important to this study, the zirconia surface used in group A prevented these deficiencies. Therefore, these results indicate that nanostructured zirconia surface created on clinical implants by ion beam-assisted deposition may prevent impaired osseointegration in elderly patients by promoting quicker maturation of peri-implant woven bone.

A morphological analysis on the osteocytic lacunar canalicular system in bone surrounding dental implants

Osseointegration is the most preferable interface of dental implants and newly formed bone. However, the cavity preparation for dental implants often gives rise to empty lacunae or pyknotic osteocytes in bone surrounding the dental implant. This study aimed to examine the chronological alternation of osteocytes in the bone surrounding the titanium implants using a rat model. The distribution of the osteocytic lacunar canalicular system (OLCS) in bone around the titanium implants was examined by silver impregnation according to Bodian's staining. We also performed double staining for alkaline phosphatase (ALP) and tartrate-resistant acid phosphatase (TRAP), as well as immunohistochemistry for fibroblast growth factor (FGF) 23--a regulator for the serum concentration of phosphorus--and sclerostin, which has been shown to inhibit osteoblastic activities. Newly formed bone and the injured bone at the early stage exhibited an irregularly distributed OLCS and a few osteocytes positive for sclerostin or FGF23, therefore indicating immature bone. Osteocytes in the surrounding bone from Day 20 to Month 2 came to reveal an intense immunoreactivity for sclerostin. Later on, the physiological bone remodeling gradually replaced such immature bone into a compact profile bearing a regularly arranged OLCS. As the bone was remodeled, FGF23 immunoreactivity became more intense, but sclerostin became less so in the well-arranged OLCS. In summary, it seems likely that OLCS in the bone surrounding the dental implants is damaged by cavity formation, but later gradually recovers as bone remodeling takes place, ultimately inducing mature bone.