Histomorphometric analysis of pure titanium implants with porous surface versus rough surface

Mechanical Characterisation and Numerical Modelling of TPMS-Based Gyroid and Diamond Ti6Al4V Scaffolds for Bone Implants: An Integrated Approach for Translational Consideration

Additive manufacturing has been used to develop a variety of scaffold designs for clinical and industrial applications. Mechanical properties (i.e., compression, tension, bending, and torsion response) of these scaffolds are significantly important for load-bearing orthopaedic implants. In this study, we designed and additively manufactured porous metallic biomaterials based on two different types of triply periodic minimal surface structures (i.e., gyroid and diamond) that mimic the mechanical properties of bone, such as porosity, stiffness, and strength. Physical and mechanical properties, including compressive, tensile, bending, and torsional stiffness and strength of the developed scaffolds, were then characterised experimentally and numerically using finite element method. Sheet thickness was constant at 300 μm, and the unit cell size was varied to generate different pore sizes and porosities. Gyroid scaffolds had a pore size in the range of 600-1200 μm and a porosity in the range of 54-72%, respectively. Corresponding values for the diamond were 900-1500 μm and 56-70%. Both structure types were validated experimentally, and a wide range of mechanical properties (including stiffness and yield strength) were predicted using the finite element method. The stiffness and strength of both structures are comparable to that of cortical bone, hence reducing the risks of scaffold failure. The results demonstrate that the developed scaffolds mimic the physical and mechanical properties of cortical bone and can be suitable for bone replacement and orthopaedic implants. However, an optimal design should be chosen based on specific performance requirements.

Understanding the Stress Distribution on Anatomic Customized Root-Analog Dental Implant at Bone-Implant Interface for Different Bone Densities

The aim of this study is to assess the stress distribution on the bone tissue and bone-implant interface of a customized anatomic root-analog dental implant (RAI) by means of finite element analysis (FEA) for different types of bone density. A mandibular right second premolar was selected from the CBCT database. A DICOM file was converted to an STL file to create a CAD model in FEA software. The bone boundary model was created, while bone density types I-IV were determined. Von Mises stress was measured at bone tissues and bone-implant interfaces. To validate the models, the RAI was 3D printed through a laser powder-bed fusion (L-PBF) approach. The results revealed that all RAI designs could not cause plastic deformation or fracture resulting in lower stress than the ultimate tensile stress of natural bone and implant. Compared to a conventional screw-type implant, RAIs possess a more favorable stress distribution pattern around the bone tissue and the bone-implant interface. The presence of a porous structure was found to reduce the stress at cancellous bone in type IV bone density.

Osseointegration Improvement of Co-Cr-Mo Alloy Produced by Additive Manufacturing

Cobalt-base alloys (Co-Cr-Mo) are widely employed in dentistry and orthopedic implants due to their biocompatibility, high mechanical strength and wear resistance. The osseointegration of implants can be improved by surface modification techniques. However, complex geometries obtained by additive manufacturing (AM) limits the efficiency of mechanical-based surface modification techniques. Therefore, plasma immersion ion implantation (PIII) is the best alternative, creating nanotopography even in complex structures. In the present study, we report the osseointegration results in three conditions of the additively manufactured Co-Cr-Mo alloy: (i) as-built, (ii) after PIII, and (iii) coated with titanium (Ti) followed by PIII. The metallic samples were designed with a solid half and a porous half to observe the bone ingrowth in different surfaces. Our results revealed that all conditions presented cortical bone formation. The titanium-coated sample exhibited the best biomechanical results, which was attributed to the higher bone ingrowth percentage with almost all medullary canals filled with neoformed bone and the pores of the implant filled and surrounded by bone ingrowth. It was concluded that the metal alloys produced for AM are biocompatible and stimulate bone neoformation, especially when the Co-28Cr-6Mo alloy with a Ti-coated surface, nanostructured and anodized by PIII is used, whose technology has been shown to increase the osseointegration capacity of this implant.

Simultaneous engineering of nanofillers and patterned surface macropores of graphene/hydroxyapatite/polyetheretherketone ternary composites for potential bone implants

Incorporating bioactive nanofillers and creating porous surfaces are two common strategies used to improve the tissue integration of polyetheretherketone (PEEK) material. However, few studies have reported the combined use of both strategies to modify PEEK. Herein, for the first time, dual nanoparticles of graphene oxide (GO) and hydroxyapatite (HAp) were incorporated into PEEK matrix to obtain ternary composites that were laser machined to create macropores with diameters ranging from 200 μm to 600 μm on the surfaces. The surface morphology and chemistry, mechanical properties, and cellular responses of the composites were investigated. The results show that micropatterned pores with a depth of 50 μm were created on the surfaces of the composites, which do not significantly affect the mechanical properties of the resultant composites. More importantly, the incorporation of GO and HAp significantly improves the cell adhesion and proliferation on the surface of PEEK. Compared to the smooth surface composite, the composites with macroporous surface exhibit markedly enhanced cell viability. The combined use of nanofillers and surface macropores may be a promising way of improving tissue integration of PEEK for bone implants.

Peri-Implant bone response around porous-surface dental implants: A preclinical meta-analysis

Introduction

This meta-analysis of relevant animal studies was conducted to assess whether the use of porous-surface implants improves osseointegration compared to the use of non-porous-surface implants.

Material and methods

An electronic search of PubMed (MEDLINE) resulted in the selection of ten animal studies (out of 865 publications) for characterization and quality assessment. Risk of bias assessment indicated poor reporting for the majority of studies. The results for bone-implant contact (BIC%) and peri-implant bone formation (BF%) were extracted from the eligible studies and used for the meta-analysis. Data for porous-surface implants were compared to those for non-porous-surface implants, which were considered as the controls.

Results

The random-effects meta-analysis showed that the use of porous-surface implants did not significantly increase overall BIC% (mean difference or MD: 3.63%; 95% confidence interval or 95% CI: −1.66 to 8.91; p = 0.18), whereas it significantly increased overall BF% (MD: 5.43%; CI: 2.20 to 8.67; p = 0.001), as compared to the controls.

Conclusion

Porous-surface implants promote osseointegration with increase in BF%. However, their use shows no significant effect on BIC%. Further preclinical and clinical investigations are required to find conclusive evidence on the effect of porous-surface implants.

Osseointegration of 3D porous and solid Ti-6Al-4V implants - Narrow gap push-out testing and experimental setup considerations

Porosity in titanium alloy materials improves the bony integration and mechanical properties of implants. In certain areas of application such as vertebral spacers or trabecular bone replacement (e.g. wedge augmentation in prosthetics), surface structures are desirable that promote bone integration and have biomechanical properties that are resistant to intraosseous load transfers and at the same time resemble the stiffness of bone to possible reduce the risk of stress shielding. In the present study, we investigated the biomechanical push-out behavior of an open-porous Ti-6Al-4V material that was produced in a space-holder and sintering method creating a 3-D through-pores trabecular design that corresponds with the inhomogeneity and size relationships of trabecular bone. The short-term and mid-term effects of the material properties on osseointegration in a biomechanical push-out study were compared to those of to a conventional solid Ti-6Al-4V material. In order to raise the measurement accuracy we implemented a strict study protocol. Pairs of cylindrical implants with a porosity of 49% and an average pore diameter of 400 μm and equal sized solid, corundum blasted devices as reference were bilaterally implanted press fit in the lateral femoral condyles of 14 rabbits. After sacrifice at 4 and 12 weeks, a push-out test was performed while the test set-up was designed to ensure conformity of implant axes and direction of applied force. Maximum holding force, Young's modulus, and mode of failure were recorded. Results of maximum push-out force (F-max) revealed a significant material effect (p < 0.05) in favor of porous implants after 4 weeks of osseohealing (6.39 vs. 3.36 N/mm²) as well as after 12 weeks of osseoremodeling (7.58 vs. 4.99 N/mm²). Evaluation of the failure mode resulted in three different types of displacement characteristics, which revealed a different mechanism of osseous anchoring between the two types of implants and substantiate the F-max and Young's modulus results. Conclusively, the porous implant offers surface properties that significantly improve its osseous stability compared to solid material under experimental conditions. In addition, we have optimized our study protocol for biomechanical push-out tests to produce precise and comparable results.

Evaluation of Peri-Implant Bone Grafting Around Surface-Porous Dental Implants: An In Vivo Study in a Goat Model

Dental implants with surface-porous designs have been recently developed. Clinically, peri-implant bone grafting is expected to promote early osseointegration and bone ingrowth when applied with surface-porous dental implants in challenging conditions. The aim of this study was to comparatively analyze peri-implant bone healing around solid implants and surface-porous implants with and without peri-implant bone grafting, using biomechanical and histomorphometrical assessment in a goat iliac bone model. A total of 36 implants (4.1 mm wide, 11.5 mm long) divided into three groups, solid titanium implant (STI; n = 12), porous titanium implants (PTI; n = 12) and PTI with peri-implant bone grafting using biphasic calcium phosphate granules (PTI + BCP; n = 12), were placed bilaterally in the iliac crests of six goats. The goats were sacrificed seven weeks post-operatively and then subjected to biomechanical (n = 6 per group) and histomorphometrical (n = 6 per group) assessment. The biomechanical assessment revealed no significant differences between the three types of implants. Although the peri-implant bone-area (PIBA%) measured by histomorphometry (STI: 8.63 ± 3.93%, PTI: 9.89 ± 3.69%, PTI + BCP: 9.28 ± 2.61%) was similar for the three experimental groups, the percentage of new bone growth area (BGA%) inside the porous implant portion was significantly higher (p < 0.05) in the PTI group (10.67 ± 4.61%) compared to the PTI + BCP group (6.50 ± 6.53%). These data demonstrate that peri-implant bone grafting around surface-porous dental implants does not significantly accelerate early osseointegration and bone ingrowth.

Anterior Lumbar Interbody Fusion Using a Personalized Approach: Is Custom the Future of Implants for Anterior Lumbar Interbody Fusion Surgery?

BACKGROUND

Spine surgery has the potential to benefit from the use of three-dimensional (3D) printing technology (additive manufacturing), particularly in cases of complex anatomic diseases. Custom devices have the potential to reduce operative times, reduce blood loss, provide immediate stability, and improve fusion rates.

CASE DESCRIPTION

A 34-year-old man presented with 3-year history of bilateral L5 radiculopathy caused by bilateral L5 pars defect, L5/S1 degenerative disc disease, and severe foraminal stenosis. Anterior lumbar interbody fusion surgery was determined to be the most efficacious method for distraction of the disc space to increase the foraminal volume and stabilization of the motion segment. Surgical decompression and reconstruction was performed in combination with a 3D printed custom interbody implant. Custom design features included corrective angulation to restore lumbar lordosis, preplanned screw holes in the 3D implant, and device end plate interface geometry designed to shape-match with the patient's end plate anatomy.

CONCLUSIONS

The use of patient-specific implants has reduced operative time significantly, which may offset costs of increased time spent preplanning the procedure. Surgical procedures can be preplanned using 3D models reconstructed from patient computed tomography and/or magnetic resonance imaging scans. Planning can be aided by 3D printed models of patient anatomy, which surgeons can use in training before performing complex procedures. When considering implants and prostheses, the use of 3D printing allows a superior anatomic fit for the patient compared with generic devices, with the potential to improve restoration of nonpathologic anatomy.

In vitro and in vivo biological performance of porous Ti alloys prepared by powder metallurgy

Titanium (Ti) and Ti-6 Aluminium-4 Vanadium alloys are the most common materials in implants composition but β type alloys are promising biomaterials because they present better mechanical properties. Besides the composition of biomaterial, many factors influence the performance of the biomaterial. For example, porous surface may modify the functional cellular response and accelerate osseointegration. This paper presents in vitro and in vivo evaluations of powder metallurgy-processed porous samples composed by different titanium alloys and pure Ti, aiming to show their potential for biomedical applications. The porous surfaces samples were produced with different designs to in vitro and in vivo tests. Samples were characterized with scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS) and elastic modulus analyses. Osteogenic cells from newborn rat calvaria were plated on discs of different materials: G1—commercially pure Ti group (CpTi); G2—Ti-6Al-4V alloy; G3—Ti-13 Niobium-13 Zirconium alloy; G4—Ti-35 Niobium alloy; G5—Ti-35 Niobium-7 Zirconium-5 Tantalum alloy. Cell adhesion and viability, total protein content, alkaline phosphatase activity, mineralization nodules and gene expression (alkaline phosphatase, Runx-2, osteocalcin and osteopontin) were assessed. After 2 and 4 weeks of implantation in rabbit tibia, bone ingrowth was analyzed using micro-computed tomography (μCT). EDS analysis confirmed the material production of each group. Metallographic and SEM analysis revealed interconnected pores, with mean pore size of 99,5μm and mean porosity of 42%, without significant difference among the groups (p>0.05). The elastic modulus values did not exhibit difference among the groups (p>0.05). Experimental alloys demonstrated better results than CpTi and Ti-6Al-4V, in gene expression and cytokines analysis, especially in early experimental periods. In conclusion, our data suggests that the experimental alloys can be used for biomedical application since they contributed to excellent cellular behavior and osseointegration besides presenting lower elastic modulus.

L5 En-Bloc Vertebrectomy with Customized Reconstructive Implant: Comparison of Patient-Specific Versus Off-the-Shelf Implant

BACKGROUND

Spine surgery has the potential to benefit from additive manufacturing/3-dimensional printing (3DP) technology with complex anatomical pathologies requiring reconstruction, with the potential to customize surgery to reduce operative times, reduce blood loss, provide immediate stability, and potentially improve fusion rates. We report a unique case of intraoperative trial placement of a custom patient-specific implant (PSI) versus the final implantation of a customizable off-the-shelf (OTS) implant. Data collected for comparison included time to implant, ease of implantation, firmness of press-fit, and fixation options after implantation.

CASE DESCRIPTION

A 64-year-old man presented with low back pain. Computed tomography and magnetic resonance imaging revealed a solitary lesion in the L5 vertebral body, confirmed by positron emission tomography scan. Removal of the L5 vertebral body was performed, and reconstruction was achieved with an expandable cage. The time of implant insertion was minimal with the PSI (90 seconds) versus the OTS (>40 minutes). Immediate press-fit and "firmness" of implantation was clearly superior with the PSI, although this was an intraoperative subjective assessment. Other benefits include integral fixation that is predetermined with the PSI, reduced time and blood loss, and ease of bone grafting with a PSI.

CONCLUSIONS

Use of 3DP has been able to reduce operative time significantly. Surgeons can train before performing complex procedures, which enhances their presurgical planning, with the goal to maximize patient outcomes. When considering implants and prostheses, the use of 3DP allows a superior anatomical fit for the patient, with the potential to improve restoration of anatomy.

Behavior of Human Osteoblast Cells Cultured on Titanium Discs in Relation to Surface Roughness and Presence of Melatonin

The aim of this work was to observe the behavior of osteoblast cells cultured in vitro on titanium discs in relation to disc surface roughness and the addition of melatonin to the culture medium. MG63 osteoblast cells were cultivated on 120 Grade 5 Ti divided into three groups: Group E, treated with dual acid etch; Group EP, treated with dual acid etch and calcium phosphate; and Group M, machined. Surface roughness was examined under a laser scanning confocal microscope (CLSM) and scanning electron microscopy (SEM). The proliferation and morphology of cells were determined under fluorescence microscopy and SEM. Messenger ribonucleic acid (mRNA) of different genes related to osteoblastic differentiation was quantified by means of real-time quantitative polymerase chain reaction (RT-PCR) assay. The greatest surface roughness was found in Group EP (Ra 0.354 µm), followed by Group E (Ra 0.266 µm), and Group M (Ra 0.131 µm), with statistically significant differences between the groups (p < 0.001). In the presence of melatonin a trend to a higher cell proliferation was observed in all groups although significant differences were only found in Group M (p = 0.0079). Among the genes studied, a significant increase in phosphate-regulating neutral endopeptidase, X-linked (PHEX) expression was observed in cells cultured on EP discs. The addition of melatonin increased osteoblast cell proliferation and differentiation, and may favor the osseointegration of dental implants.

Calcium Phosphate Bioceramics: A Review of Their History, Structure, Properties, Coating Technologies and Biomedical Applications

Calcium phosphate (CaP) bioceramics are widely used in the field of bone regeneration, both in orthopedics and in dentistry, due to their good biocompatibility, osseointegration and osteoconduction. The aim of this article is to review the history, structure, properties and clinical applications of these materials, whether they are in the form of bone cements, paste, scaffolds, or coatings. Major analytical techniques for characterization of CaPs, in vitro and in vivo tests, and the requirements of the US Food and Drug Administration (FDA) and international standards from CaP coatings on orthopedic and dental endosseous implants, are also summarized, along with the possible effect of sterilization on these materials. CaP coating technologies are summarized, with a focus on electrochemical processes. Theories on the formation of transient precursor phases in biomineralization, the dissolution and reprecipitation as bone of CaPs are discussed. A wide variety of CaPs are presented, from the individual phases to nano-CaP, biphasic and triphasic CaP formulations, composite CaP coatings and cements, functionally graded materials (FGMs), and antibacterial CaPs. We conclude by foreseeing the future of CaPs.

Fabrication of Mechanically Tunable and Bioactive Metal Scaffolds for Biomedical Applications

Biometal systems have been widely used for biomedical applications, in particular, as load-bearing materials. However, major challenges are high stiffness and low bioactivity of metals. In this study, we have developed a new method towards fabricating a new type of bioactive and mechanically reliable porous metal scaffolds-densified porous Ti scaffolds. The method consists of two fabrication processes, 1) the fabrication of porous Ti scaffolds by dynamic freeze casting, and 2) coating and densification of the porous scaffolds. The dynamic freeze casting method to fabricate porous Ti scaffolds allowed the densification of porous scaffolds by minimizing the chemical contamination and structural defects. The densification process is distinctive for three reasons. First, the densification process is simple, because it requires a control of only one parameter (degree of densification). Second, it is effective, as it achieves mechanical enhancement and sustainable release of biomolecules from porous scaffolds. Third, it has broad applications, as it is also applicable to the fabrication of functionally graded porous scaffolds by spatially varied strain during densification.

Osseointegration of polyethylene implants coated with titanium and biomimetically or electrochemically deposited hydroxyapatite in a rabbit model

PURPOSE

The aim of this study was to evaluate the osseointegration of a new coating directly deposited on PE at room temperature.

METHODS

Thirty-six (36) male New Zealand rabbits were randomly assigned to receive one out of three types of implants: two tested implants, i.e. PE implant coated with TiPVD and biomimetic HA (biomimetic), PE implant coated with TiPVD and electrolytic HA (electrolytic), and positive control made of massive microrough titanium coated with plasma sprayed HA (TiHAPS). Osseointegration was evaluated by histomorphometry (bone tissue in contact [BIC]), mineralized bone area [MBA]) and mechanical testing (push-out test, interfacial shear strength [ISS]) at six and 12 weeks in the distal femurs.

RESULTS

For BIC there were no differences between the groups at six (p = 0.98) and 12 weeks (p = 0.13). For MBA, no statistically significant difference was measured between groups at six (p = 0.52) and 12 weeks (p = 0.57). At six weeks, interfacial shear strength (ISS) was significantly higher (p = 0.01) for TiHAPs implants compared to biomimetic and electrolytic implants. This difference was not significant at 12 weeks (p = 0.92).

CONCLUSION

The osseointegration of biomimetic and electrolytic implants was equivalent to a positive control at 12 weeks.

Repair of segmental long bone defect in a rabbit radius nonunion model: comparison of cylindrical porous titanium and hydroxyapatite scaffolds

A segmental long bone defect in a rabbit radius nonunion model was repaired using cylindrical porous titanium (Ti) and hydroxyapatite (HA) scaffolds. Each scaffold was produced using the same method, namely, a slurry foaming method. Repairing ability was characterized using x-radiographic score 12 and 24 weeks postprocedure; failure load of the radius-ulna construct, under three-point bending, 12 weeks postprocedure; and the percentage of newly formed bone within the implant, 12 and 24 weeks after postprocedure. For each of these parameters, the difference in the results when porous Ti scaffold was used compared with when HA scaffolds were used was not significant; both porous scaffolds showed excellent repairing ability. Because the trabecular bone is a porous tissue, the interconnected porous scaffolds have the advantages of natural bone, and vasculature can grow into the porous structure to accelerate the osteoconduction and osteointegration between the implant and bone. The porous Ti scaffold not only enhanced the bone repair process, similar to porous HA scaffolds, but also has superior biomechanical properties. The present results suggest that porous Ti scaffolds may have promise for use in the clinical setting.

Immediate loading of trabecular metal-enhanced titanium dental implants: interim results from an international proof-of-principle study

OBJECTIVES

A 3-year proof-of-principle study was initiated to evaluate the clinical efficacy of immediately loading titanium dental implants with surfaces enhanced with porous tantalum trabecular metal (PTTM). First-year interim results are presented.

MATERIALS AND METHODS

Healthy, partially edentulous patients (n = 30) were enrolled and treated per protocol (minimum insertion torque: ≥35 Ncm) with 37 implants placed in one or two premolar or molar locations in either jaw (study group). Implants were immediately provisionalized out of occlusion with single acrylic crowns. After 7 to 14 days of soft tissue healing, implants were definitively restored in occlusion with ceramometal crowns. Because most study group implants (54.1%, n = 20) had less than 1 year of clinical follow-up, this interim analysis was limited to the first 22 consecutively placed implants in 17 subjects (10 women and 7 men) who completed 1 year of clinical follow-up to date (focus group).

RESULTS

To date, one implant failed to integrate in the study group (survival = 97.3%, n = 36/37). Focus group implants achieved 100% (n = 22/22) survival with 0.43 ± 0.41 mm of mean marginal bone loss. There were no serious complications.

CONCLUSION

Early clinical findings indicated that immediate loading of PTTM implants was safe and effective under the controlled study conditions.

Experimental study on the osseointegration of foam TiC/Ti composites

Macroporous ceramics have demonstrated osteoconductive properties because of their biocompatibility and 3D macroporous structure, and these materials have recently been widely studied as bone replacement materials. The foam TiC/Ti composites discussed in this study have good mechanical properties, balancing out metallic toughness and ceramic strength. Furthermore, because of the high porosity and pore connectivity of these TiC/Ti composites, they have the potential to be a new bone replacement material. The purpose of this study was to evaluate the osseointegration of foam TiC/Ti composites, preliminarily discuss the TiC/Ti ossification mechanism, and to obtain reliable data on the use of foam TiC/Ti composites as bone replacement materials. The foam TiC/Ti composites were sited in 40 Japanese white rabbits for 4, 8, 12 and 24 weeks. The foam TiC/Ti composites were compared to foam SiC. M-CT (micro-computed tomography) analysis, histological analysis, SEM (scanning electron microscopy) observation and EDS (energy-dispersive x-ray spectrometer) analysis were conducted to estimate the osseointegration of the materials. The histological observations and quantitative analysis exhibited significantly more ossification area (volume), trabeculae maturity, and calcium and phosphorus content in the foam TiC/Ti composites compared to the foam SiC (p < 0.05). The results from this study suggest that the foam TiC/Ti composites possess good osseointegration capacity and have the potential to be a new bone replacement material.

Novel production method of porous surface Ti samples for biomedical application

A porous implant material with adequate pore structure and the appropriate mechanical properties for bone ingrowth has long been sought. This article presents details of the development, characterization and in vivo evaluations of powder metallurgy-processed titanium samples exhibiting a dense core with an integrated porous surface for biomedical applications. A space-holder method was applied to investigate the effects of different percentages and particle sizes of the urea on bone neoformation in 30 rabbits. The samples were previously characterized using scanning electron microscopy and mechanical testing. After 8 and 12 weeks of implantation, bone ingrowth was histologically and histometrically analyzed and push-out testing was performed. This study demonstrated that the association of a dense core integrated with the greatest number of interconnected pores of the smallest size is a promising biomaterial for bone tissue engineering. This sample exhibits appropriate mechanical properties combined with increased bone ingrowth, providing enhanced resistance to displacement.

The effect of bone ingrowth depth on the tensile and shear strength of the implant-bone e-beam produced interface

New technologies, such as selective electron beam melting, allow to create complex interface structures to enhance bone ingrowth in cementless implants. The efficacy of such structures can be tested in animal experiments. Although animal studies provide insight into the biological response of new structures, it remains unclear how ingrowth depth is related to interface strength. Theoretically, there could be a threshold of ingrowth, above which the interface strength does not further increase. To test the relationship between depth and strength we performed a finite element study on micro models with simulated uncoated and hydroxyapatite (HA) coated surfaces. We examined whether complete ingrowth is necessary to obtain a maximal interface strength. An increase in bone ingrowth depth did not always enhance the bone-implant interface strength. For the uncoated specimens a plateau was reached at 1,500 μm of ingrowth depth. For the specimens with a simulated HA coating, a bone ingrowth depth of 500 μm already yielded a substantial interface strength, and deeper ingrowth did not enhance the interface strength considerably. These findings may assist in optimizing interface morphology (its depth) and in judging the effect of bone ingrowth depth on interface strength.

Validation of an experimental polyurethane model for biomechanical studies on implant supported prosthesis--tension tests

OBJECTIVES

The complexity and heterogeneity of human bone, as well as ethical issues, frequently hinder the development of clinical trials. The purpose of this in vitro study was to determine the modulus of elasticity of a polyurethane isotropic experimental model via tension tests, comparing the results to those reported in the literature for mandibular bone, in order to validate the use of such a model in lieu of mandibular bone in biomechanical studies.

MATERIAL AND METHODS

Forty-five polyurethane test specimens were divided into 3 groups of 15 specimens each, according to the ratio (A/B) of polyurethane reagents (PU-1: 1/0.5, PU-2: 1/1, PU-3: 1/1.5).

RESULTS

Tension tests were performed in each experimental group and the modulus of elasticity values found were 192.98 MPa (SD=57.20) for PU-1, 347.90 MPa (SD=109.54) for PU-2 and 304.64 MPa (SD=25.48) for PU-3.

CONCLUSION

The concentration of choice for building the experimental model was 1/1.

Evaluation of bone ingrowth into porous titanium implant: histomorphometric analysis in rabbits

A porous material for bone ingrowth with adequate pore structure and appropriate mechanical properties has long been sought as the ideal bone-implant interface. This study aimed to assess in vivo the influence of three types of porous titanium implant on the new bone ingrowth. The implants were produced by means of a powder metallurgy technique with different porosities and pore sizes: Group 1 = 30 % and 180 µm; Group 2 = 30% and 300 µm; and Group 3 = 40% and 180 µm;. Six rabbits received one implant of each type in the right and left tibiae and were sacrificed 8 weeks after surgery for histological and histomorphometric analyses. Histological analysis confirmed new bone in contact with the implant, formed in direction of pores. Histomorphometric evaluation demonstrated that the new bone formation was statistically significantly lower in the group G1 than in group G3, (P = 0.023). Based on these results, increased porosity and pore size were concluded to have a positive effect on the amount of bone ingrowth.

Enhanced osseointegration of grit-blasted, NaOH-treated and electrochemically hydroxyapatite-coated Ti-6Al-4V implants in rabbits

Osseointegration, in terms of the bone apposition ratio (BAR) and the new bone area (NBA), was measured by backscattered electron imaging. The results were compared for four implant types: grit-blasted and NaOH-treated Ti-6Al-4V (Uncoated-NaOH), electrodeposited with hydroxyapatite without alkali treatment (ED-HAp), electrodeposited with hydroxyapatite after alkali treatment (NaOH-ED-HAp), and plasma sprayed with hydroxyapatite (PS-HAp). No heat treatment was done after soaking in NaOH. The implants were press fitted into the intramedullary canal of mature New Zealand white rabbits and analyzed, both at the diaphyseal and at the metaphyseal zones, either 1week or 12weeks after surgery. NaOH-ED-HAp already exhibited a higher BAR value than the ED-HAp at 1week, and was as good as the commercial PS-HAp at 12weeks. The NBA value for NaOH-ED-HAp at 12weeks was the highest. The higher content of octacalcium phosphate in NaOH-ED-HAp, as evident from the X-ray photoelectron spectroscopy analysis of the oxygen shake-up peaks, and the associated increase in the solubility of this coating in vivo are considered responsible for the enhanced osseointegration. Taking into account also the reduced occurrence of delamination and the inherent advantages of the electrodeposition process, electrodeposition of HAp following soaking in NaOH may become an attractive alternative for the traditional plasma-sprayed process for coating of orthopedic and dental implants.