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Döring J, Bormann T, Buchholz A, Hembus J, Rothammer B, Uhler M. [Tribology in arthroplasty : Friction and wear, a key to a long lifetime]. ORTHOPADIE (HEIDELBERG, GERMANY) 2024; 53:479-486. [PMID: 38833160 DOI: 10.1007/s00132-024-04520-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/02/2024] [Indexed: 06/06/2024]
Abstract
This article is intended to highlight one of the key roles in endoprosthetic treatment with artificial implants and the extension of service life. Like every joint, artificial joints are subject to the physical laws of friction and wear-in short, tribology. Material pairings, surfaces and mechanisms of action in particular play a decisive role here. The special features and current findings relating to the three largest synovial joints (hip, knee and shoulder) will be discussed in detail and suggestions will be made for future developments. Continuous developments in the field of the tribology of artificial joints can massively improve care for patients. The revision figures and reasons already show the success of individual improvements in recent years.
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Affiliation(s)
- Joachim Döring
- Orthopädische Universitätsklinik, Medizinische Fakultät, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland.
| | - Therese Bormann
- Sektion für Biomechanik und Implantatforschung, Klinik für Orthopädie, Universitätsklinikums Heidelberg, Schlierbacher Landstraße 200a, 69118, Heidelberg, Deutschland
| | - Adrian Buchholz
- Orthopädische Universitätsklinik, Medizinische Fakultät, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland
| | - Jessica Hembus
- Forschungslabor für Biomechanik und Implantattechnologie, Orthopädische Klinik, Universitätsmedizin Rostock, Doberaner Str. 142, 18057, Rostock, Deutschland
| | - Benedict Rothammer
- Lehrstuhl für Konstruktionstechnik, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
| | - Maximilian Uhler
- Sektion für Biomechanik und Implantatforschung, Klinik für Orthopädie, Universitätsklinikums Heidelberg, Schlierbacher Landstraße 200a, 69118, Heidelberg, Deutschland
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Sellin ML, Seyfarth-Sehlke A, Aziz M, Fabry C, Wenke K, Høl PJ, Rios-Mondragon I, Cimpan MR, Frank M, Bader R, Jonitz-Heincke A. Isolation of TiNbN wear particles from a coated metal-on-metal bearing: Morphological characterization and in vitro evaluation of cytotoxicity in human osteoblasts. J Biomed Mater Res B Appl Biomater 2024; 112:e35357. [PMID: 38247242 DOI: 10.1002/jbm.b.35357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 10/18/2023] [Accepted: 11/15/2023] [Indexed: 01/23/2024]
Abstract
To improve the wear resistance of articulating metallic joint endoprostheses, the surfaces can be coated with titanium niobium nitride (TiNbN). Under poor tribological conditions or malalignment, wear can occur on these implant surfaces in situ. This study investigated the biological response of human osteoblasts to wear particles generated from TiNbN-coated hip implants. Abrasive particles were generated in a hip simulator according to ISO 14242-1/-2 and extracted with Proteinase K. Particle characteristics were evaluated by electron microscopy and energy dispersive x-ray spectroscopy (EDS), inductively coupled plasma mass spectrometry (ICP-MS) and dynamic light scattering (DLS) measurements. Human osteoblasts were exposed to different particle dilutions (1:20, 1:50, and 1:100), and cell viability and gene expression levels of osteogenic markers and inflammatory mediators were analyzed after 4 and 7 days. Using ICP-MS, EDS, and DLS measurements, ~70% of the particles were identified as TiNbN, ranging from 39 to 94 nm. The particles exhibited a flat and subangular morphology. Exposure to particles did not influence cell viability and osteoblastic differentiation capacity. Protein levels of collagen type 1, osteoprotegerin, and receptor activator of nuclear factor κB ligand were almost unaffected. Moreover, the pro-inflammatory response via interleukins 6 and 8 was minor induced after particle contact. A high number of TiNbN wear particles only slightly affected osteoblasts' differentiation ability and inflammatory response compared to metallic particles. Nevertheless, further studies should investigate the role of these particles in peri-implant bone tissue, especially concerning other cell types.
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Affiliation(s)
- Marie-Luise Sellin
- Department of Orthopaedics, Biomechanics and Implant Technology Research Laboratory, Rostock University Medical Center, Rostock, Germany
| | - Anika Seyfarth-Sehlke
- Department of Orthopaedics, Biomechanics and Implant Technology Research Laboratory, Rostock University Medical Center, Rostock, Germany
| | - Mahammad Aziz
- Department of Orthopaedics, Biomechanics and Implant Technology Research Laboratory, Rostock University Medical Center, Rostock, Germany
| | | | | | - Paul Johan Høl
- Department of Orthopaedic Surgery, Biomatlab, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, Biomaterials, University of Bergen, Bergen, Norway
| | - Ivan Rios-Mondragon
- Department for Clinical Dentistry Biomaterials, University of Bergen, Bergen, Norway
| | - Mihaela Roxana Cimpan
- Department for Clinical Dentistry Biomaterials, University of Bergen, Bergen, Norway
| | - Marcus Frank
- Medical Biology and Electron Microscopy Center, Rostock University Medical Center, Rostock, Germany
- Department Life, Light and Matter, University of Rostock, Rostock, Germany
| | - Rainer Bader
- Department of Orthopaedics, Biomechanics and Implant Technology Research Laboratory, Rostock University Medical Center, Rostock, Germany
- Department Life, Light and Matter, University of Rostock, Rostock, Germany
| | - Anika Jonitz-Heincke
- Department of Orthopaedics, Biomechanics and Implant Technology Research Laboratory, Rostock University Medical Center, Rostock, Germany
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Electrochemical, Tribological and Biocompatible Performance of Electron Beam Modified and Coated Ti6Al4V Alloy. Int J Mol Sci 2021; 22:ijms22126369. [PMID: 34198700 PMCID: PMC8232333 DOI: 10.3390/ijms22126369] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/31/2021] [Accepted: 06/11/2021] [Indexed: 12/30/2022] Open
Abstract
Vacuum cathodic arc TiN coatings with overlaying TiO2 film were deposited on polished and surface roughened by electron beam modification (EBM) Ti6Al4V alloy. The substrate microtopography consisted of long grooves formed by the liner scan of the electron beam with appropriate frequencies (500 (AR500) and 850 (AR850) Hz). EBM transformed the α + β Ti6Al4V mixed structure into a single α'-martensite phase. Тhe gradient TiN/TiO2 films deposited on mechanically polished (AR) and EBM (AR500 and AR850) alloys share the same surface chemistry and composition (almost stoichiometric TiN, anatase and rutile in different ratios) but exhibit different topographies (Sa equal to approximately 0.62, 1.73, and 1.08 μm, respectively) over areas of 50 × 50 μm. Although the nanohardness of the coatings on AR500 and AR850 alloy (approximately 10.45 and 9.02 GPa, respectively) was lower than that measured on the film deposited on AR alloy (about 13.05 GPa), the hybrid surface treatment offered improvement in critical adhesive loads, coefficient of friction, and wear-resistance of the surface. In phosphate buffer saline, all coated samples showed low corrosion potentials and passivation current densities, confirming their good corrosion protection. The coated EBM samples cultured with human osteoblast-like MG63 cells demonstrated increased cell attachment, viability, and bone mineralization activity especially for the AR500-coated alloy, compared to uncoated polished alloy. The results underline the synergetic effect between the sub-micron structure and composition of TiN/TiO2 coating and microarchitecture obtained by EBM.
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Louwerens JKG, Hockers N, Achten G, Sierevelt IN, Nolte PA, van Hove RP. No clinical difference between TiN-coated versus uncoated cementless CoCrMo mobile-bearing total knee arthroplasty; 10-year follow-up of a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc 2021; 29:750-756. [PMID: 32367201 DOI: 10.1007/s00167-020-05997-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 04/10/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Improvement of biomechanical properties of cobalt-chromium-molybdenum (CoCrMo) implant surface and reduction of adhesive wear is achieved by titanium-nitride (TiN) coating in vitro. Less pain, higher postoperative outcome scores and a lower revision rate after TKA with a TiN-coated CoCrMo TKA compared with uncoated CoCrMo TKA after 10-year follow-up was hypothesized. METHODS In a double-blinded RCT, 101 patients received a cementless mobile-bearing CoCrMo TKA, either TiN-coated or uncoated. The primary outcome measure was the visual analogue scale (VAS) score for pain and secondary outcome measures were the Knee Society Score (KSS), Oxford Knee Score (OKS), revision rate and adverse events. Patients were assessed at 6 weeks, 6 months, 1 year, 5 years and 10 years, postoperatively. RESULTS 68 patients (67%) were available for 10-year follow-up. No difference was found in any of the assessed outcome measures with a mean decrease in VAS score (31.6 ± 22.9) and a mean increase in OKS (10.9 ± 8.4), KSS (29.3 ± 31.4), KSSK (26.4 ± 18.2) and KSSF (4.1 ± 22.9). Overall revision rate was 7% (coated 6% vs uncoated 8%) without additional revision procedures between 5 and 10-year follow-up. CONCLUSIONS The in vitro potential benefits of TiN coating did not result in better clinical outcome when compared to an uncoated cementless TKA. Pain, functional outcome and revision rates were comparable after 10-year follow-up. TiN-coated cementless TKA provides comparable good long-term results, similar to uncoated cementless CoCrMo TKA. LEVEL OF EVIDENCE Level 1, Therapeutic Study NETHERLANDS TRIAL REGISTER: NL2887/NTR3033.
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Affiliation(s)
- Jan K G Louwerens
- Department of Orthopaedic Surgery, Spaarne Gasthuis Hospital, Hoofddorp, The Netherlands.
| | - Niels Hockers
- Department of Orthopaedic Surgery, Spaarne Gasthuis Hospital, Hoofddorp, The Netherlands
| | - Gijs Achten
- Department of Orthopaedic Surgery, Spaarne Gasthuis Hospital, Hoofddorp, The Netherlands
| | - Inger N Sierevelt
- Department of Orthopaedic Surgery, Spaarne Gasthuis Hospital, Hoofddorp, The Netherlands
| | - Peter A Nolte
- Department of Orthopaedic Surgery, Spaarne Gasthuis Hospital, Hoofddorp, The Netherlands
| | - Ruud P van Hove
- Department of Orthopaedic Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
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Verstappen JFM, Jin J, Koçer G, Haroon M, Jonkheijm P, Bakker AD, Klein-Nulend J, Jaspers RT. RGD-functionalized supported lipid bilayers modulate pre-osteoblast adherence and promote osteogenic differentiation. J Biomed Mater Res A 2020; 108:923-937. [PMID: 31895490 DOI: 10.1002/jbm.a.36870] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 12/20/2019] [Accepted: 12/26/2019] [Indexed: 01/27/2023]
Abstract
Biomaterial integration into bone requires optimal surface conditions to promote osteoprogenitor behavior, which is affected by integrin-binding via arginine-glycine-aspartate (RGD). RGD-functionalized supported lipid bilayers (SLBs) might be interesting as biomaterial coating in bone regeneration, because they allow integration of proteins, for example, growth factors, cytokines, and/or antibacterial agents. Since it is unknown whether and how they affect osteoprogenitor adhesion and differentiation, the aim was to investigate adhesion, focal adhesion formation, morphology, proliferation, and osteogenic potential of pre-osteoblasts cultured on RGD-functionalized SLBs compared to unfunctionalized SLBs and poly-l-lysine (PLL). After 17 hr, pre-osteoblast density on SLBs without or with RGD was similar, but lower than on PLL. Cell surface area, elongation, and number and size of phospho-paxillin clusters were also similar. Cells on SLBs without or with RGD were smaller, more elongated, and had less and smaller phospho-paxillin clusters than on PLL. OPN expression was increased on SLBs with RGD compared to PLL. Moreover, after 1 week, COL1a1 expression was increased on SLBs without or with RGD. In conclusion, pre-osteoblast adhesion and enhanced differentiation were realized for the first time on RGD-functionalized SLBs, pointing to a new horizon in the management of bone regeneration using biomaterials. Together with SLBs nonfouling nature and the possibility of adjusting SLB fluidity and peptide content make SLBs highly promising as substrate to develop innovative biomimetic coatings for biomaterials in bone regeneration.
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Affiliation(s)
- Johanna F M Verstappen
- Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Jianfeng Jin
- Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Gülistan Koçer
- Laboratory of Biointerface Chemistry, TechMed Centre and MESA+ Institute for Nanotechnology, University of Twente, Enschede, The Netherlands
| | - Mohammad Haroon
- Laboratory for Myology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Pascal Jonkheijm
- Laboratory of Biointerface Chemistry, TechMed Centre and MESA+ Institute for Nanotechnology, University of Twente, Enschede, The Netherlands
| | - Astrid D Bakker
- Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Jenneke Klein-Nulend
- Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Richard T Jaspers
- Laboratory for Myology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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Moussa M, Fontana P, Hamdan F, Cattani-Lorente M, Scherrer SS, Banakh O, Wiskott AHW, Durual S. Modulation of osteoblast behavior on TiNxOy coatings by altering the N/O stoichiometry while maintaining a high thrombogenic potential. J Biomater Appl 2015; 30:1219-29. [PMID: 26637444 DOI: 10.1177/0885328215619084] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Titanium nitride oxide (TiNxOy) coatings are known to stimulate osteoblast proliferation and osseointegration when compared to microrough titanium implants. The objectives of the present study were to determine whether the beneficial effects of TiNxOy coatings observed with implant osseointegration are dependent on N/O stoichiometry, with the final goal of optimizing these benefits. MMS: TiNxOy coatings with various N/O compositions were deposited on microrough titanium plates (Ti-SLA, 11 × 11 mm). Human primary osteoblast (hOBs) proliferation and gene expression were analyzed for a time course of three weeks, with or without additional stimulation by 1.25 (OH)2 vitamin D3 100 nM. Platelet adhesion/activation and thrombin generation were also assessed. RESULTS hOBs proliferation gradually increased with the amount of oxygen contained in the coatings. The effect was observed from day 7 to reach a maximum at day 10, with a 1.8 fold increase for the best coating as compared to Ti-SLA. SEM views indicated that cells adhered, spread and elongated faster on oxygen-rich TiNxOy films, while the differentiation process as well as the thombogenic potential was not affected. CONCLUSIONS The effect of TiNxOy coatings on osteoblast is dependent on their chemical composition; it increases with the amount of oxygen. TiNxOy coatings may act as a catalyst for cell-adhesion and proliferation early after seeding. In contrast, thrombogenicity of Ti-SLA surface is not affected by TiNxOy application.
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Affiliation(s)
- Mira Moussa
- Division of fixed prosthodontics and biomaterials, University Clinics of Dental Medicine, University of Geneva, Switzerland
| | - Pierre Fontana
- Division of Angiology and Haemostasis, University of Geneva, HUG and Geneva Platelet Group, Switzerland
| | - Farah Hamdan
- Division of fixed prosthodontics and biomaterials, University Clinics of Dental Medicine, University of Geneva, Switzerland
| | - Maria Cattani-Lorente
- Division of fixed prosthodontics and biomaterials, University Clinics of Dental Medicine, University of Geneva, Switzerland
| | - Susanne S Scherrer
- Division of fixed prosthodontics and biomaterials, University Clinics of Dental Medicine, University of Geneva, Switzerland
| | | | - Anselm H W Wiskott
- Division of fixed prosthodontics and biomaterials, University Clinics of Dental Medicine, University of Geneva, Switzerland
| | - Stéphane Durual
- Division of fixed prosthodontics and biomaterials, University Clinics of Dental Medicine, University of Geneva, Switzerland
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Titanium-Nitride Coating of Orthopaedic Implants: A Review of the Literature. BIOMED RESEARCH INTERNATIONAL 2015; 2015:485975. [PMID: 26583113 PMCID: PMC4637053 DOI: 10.1155/2015/485975] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 05/24/2015] [Indexed: 12/12/2022]
Abstract
Surfaces of medical implants can be enhanced with the favorable properties of titanium-nitride (TiN). In a review of English medical literature, the effects of TiN-coating on orthopaedic implant material in preclinical studies were identified and the influence of these effects on the clinical outcome of TiN-coated orthopaedic implants was explored. The TiN-coating has a positive effect on the biocompatibility and tribological properties of implant surfaces; however, there are several reports of third body wear due to delamination, increased ultrahigh molecular weight polyethylene wear, and cohesive failure of the TiN-coating. This might be due to the coating process. The TiN-coating process should be optimized and standardized for titanium alloy articulating surfaces. The clinical benefit of TiN-coating of CoCrMo knee implant surfaces should be further investigated.
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van Hove RP, Brohet RM, van Royen BJ, Nolte PA. No clinical benefit of titanium nitride coating in cementless mobile-bearing total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2015; 23:1833-40. [PMID: 25283502 DOI: 10.1007/s00167-014-3359-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 09/25/2014] [Indexed: 12/20/2022]
Abstract
PURPOSE Titanium nitride (TiN) coating of cobalt-chromium-molybdenum (CoCrMo) implants has shown to improve the biomechanical properties of the implant surface and to reduce adhesive wear in vitro. It is yet unknown whether TiN coating of total knee prosthesis (TKP) affects the postoperative clinical outcome of total knee arthroplasty (TKA). METHODS In a double-blind randomized controlled clinical trial, 101 patients received an uncemented mobile-bearing CoCrMo TKP, either TiN coated or uncoated. Primary outcome measure visual analogue scale (VAS) score for pain, and secondary outcome measures Knee Society Score (KSS), revision rate and adverse events, range of motion of the knee as well as knee circumference and knee skin temperature were assessed 6 weeks, 6 months, 1 year and 5 years postoperative. Repeated measures analysis was used to evaluate the postoperative outcome measures over time. RESULTS There was no difference between the two groups in VAS score, KSS, revision rate, range of motion of the knee, knee circumference and knee skin temperature. There were no adverse events that could be related to the TiN coating. CONCLUSIONS TiN-coated TKP does not influence the postoperative outcome of uncemented mobile-bearing TKA regarding postoperative pain, revision rate, range of motion, swelling and temperature of the knee. Therefore, TiN coating of CoCrMo TKP has no clinical benefit on the outcome of cementless mobile-bearing TKA. LEVEL OF EVIDENCE Therapeutic study, Level I.
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Affiliation(s)
- Ruud P van Hove
- Department of Orthopaedics, Spaarne Hospital, Spaarnepoort 1, 2134 TM, Hoofddorp, The Netherlands,
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Bone response to surface-modified titanium implants: studies on the early tissue response to implants with different surface characteristics. Int J Biomater 2013; 2013:412482. [PMID: 24174936 PMCID: PMC3794548 DOI: 10.1155/2013/412482] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 08/07/2013] [Accepted: 08/07/2013] [Indexed: 11/24/2022] Open
Abstract
In a series of experimental studies, the bone formation around systematically modified titanium implants is analyzed. In the present study, three different surface modifications were prepared and evaluated. Glow-discharge cleaning and oxidizing resulted in a highly stoichiometric TiO2 surface, while a glow-discharge treatment in nitrogen gas resulted in implants with essentially a surface of titanium nitride, covered with a very thin titanium oxide. Finally, hydrogen peroxide treatment of implants resulted in an almost stoichiometric TiO2, rich in hydroxyl groups on the surface. Machined commercially pure titanium implants served as controls. Scanning Auger Electron Spectroscopy, Scanning Electron Microscopy, and Atomic Force Microscopy revealed no significant differences in oxide thickness or surface roughness parameters, but differences in the surface chemical composition and apparent topography were observed. After surface preparation, the implants were inserted in cortical bone of rabbits and evaluated after 1, 3, and 6 weeks. Light microscopic evaluation of the tissue response showed that all implants were in contact with bone and had a large proportion of newly formed bone within the threads after 6 weeks. There were no morphological differences between the four groups. Our study shows that a high degree of bone contact and bone formation can be achieved with titanium implants of different surface composition and topography.
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