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.

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Enhancement of Bone Ingrowth into a Porous Titanium Structure to Improve Osseointegration of Dental Implants: A Pilot Study in the Canine Model

Materials ◽

10.3390/ma13143061 ◽

2020 ◽

Vol 13 (14) ◽

pp. 3061 ◽

Cited By ~ 2

Author(s):

Ji-Youn Hong ◽

Seok-Yeong Ko ◽

Wonsik Lee ◽

Yun-Young Chang ◽

Su-Hwan Kim ◽

...

Keyword(s):

Porous Structure ◽

Dental Implants ◽

Bone Growth ◽

Bone Ingrowth ◽

Test Group ◽

Porous Titanium ◽

Control Group ◽

Machined Surface ◽

Significant Difference ◽

Titanium Structure

A porous titanium structure was suggested to improve implant stability in the early healing period or in poor bone quality. This study investigated the effect of a porous structure on the osseointegration of dental implants. A total of 28 implants (14 implants in each group) were placed in the posterior mandibles of four beagle dogs at 3 months after extraction. The control group included machined surface implants with an external implant–abutment connection, whereas test group implants had a porous titanium structure added to the apical portion. Resonance frequency analysis (RFA); removal torque values (RTV); and surface topographic and histometric parameters including bone-to-implant contact length and ratio, inter-thread bone area and ratio in total, and the coronal and apical parts of the implants were measured after 4 weeks of healing. RTV showed a significant difference between the groups after 4 weeks of healing (p = 0.032), whereas no difference was observed in RFA. In the test group, surface topography showed bone tissue integrated into the porous structures. In the apical part of the test group, all the histometric parameters exhibited significant increases compared to the control group. Within the limitations of this study, enhanced bone growth into the porous structure was achieved, which consequently improved osseointegration of the implant.

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Novel Micro-CT Based 3-Dimentional Structural Analyses of Porous Biomaterials

Key Engineering Materials ◽

10.4028/www.scientific.net/kem.330-332.967 ◽

2007 ◽

Vol 330-332 ◽

pp. 967-970 ◽

Cited By ~ 2

Author(s):

B. Otsuki ◽

Mitsuru Takemoto ◽

Shunsuke Fujibayashi ◽

Masashi Neo ◽

Tadashi Kokubo ◽

...

Keyword(s):

Network Structure ◽

Bone Ingrowth ◽

Average Pore Size ◽

Three Dimensional ◽

Porous Titanium ◽

Titanium Implants ◽

Average Pore ◽

Tissue Ingrowth ◽

Porous Biomaterials

A porous structure comprises pores and pore throats with a complex three-dimensional network structure, and many investigators have described the relationship between average pore size and the amount of bone ingrowth. However, the influence of network structure or pore throats for tissue ingrowth has rarely been discussed. Bioactive porous titanium implants with 48% porosity were analyzed using specific algorithms for three-dimensional analysis of interconnectivity based on a micro focus X-ray computed tomography system. In vivo histological analysis was performed using the very same implants implanted into the femoral condyles of male rabbits for 6 weeks. This matching study revealed that more poorly differentiated pores tended to have narrow pore throats, especially in their shorter routes to the outside. Data obtained suggest that this sort of novel analysis is useful for evaluating bone and tissue ingrowth into porous biomaterials.

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Effect of pore size on bone ingrowth into porous titanium implants fabricated by additive manufacturing: An in vivo experiment

Materials Science and Engineering C ◽

10.1016/j.msec.2015.10.069 ◽

2016 ◽

Vol 59 ◽

pp. 690-701 ◽

Cited By ~ 273

Author(s):

Naoya Taniguchi ◽

Shunsuke Fujibayashi ◽

Mitsuru Takemoto ◽

Kiyoyuki Sasaki ◽

Bungo Otsuki ◽

...

Keyword(s):

Additive Manufacturing ◽

Pore Size ◽

Bone Ingrowth ◽

Porous Titanium ◽

Titanium Implants ◽

In Vivo Experiment

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3D printed Ti6Al4V bone scaffolds with different pore structure effects on bone ingrowth

Journal of Biological Engineering ◽

10.1186/s13036-021-00255-8 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Fuyuan Deng ◽

Linlin Liu ◽

Zhong Li ◽

Juncai Liu

Keyword(s):

Bone Growth ◽

Porous Scaffold ◽

Bone Ingrowth ◽

Fluid Velocity ◽

Porous Titanium ◽

Vital Role ◽

Tissue Growth ◽

Porous Scaffolds ◽

Bone Scaffolds

AbstractThe microstructure of porous scaffolds plays a vital role in bone regeneration, but its optimal shape is still unclear. In this study, four kinds of porous titanium alloy scaffolds with similar porosities (65%) and pore sizes (650 μm) and different structures were prepared by selective laser melting. Four scaffolds were implanted into the distal femur of rabbits to evaluate bone tissue growth in vivo. Micro-CT and hard tissue section analyses were performed 6 and 12 weeks after the operation to reveal the bone growth of the porous scaffold. The results show that diamond lattice unit (DIA) bone growth is the best of the four topological scaffolds. Through computational fluid dynamics (CFD) analysis, the permeability, velocity and flow trajectory inside the scaffold structure were calculated. The internal fluid velocity difference of the DIA structure is the smallest, and the trajectory of fluid flow inside the scaffold is the longest, which is beneficial for blood vessel growth, nutrient transport and bone formation. In this study, the mechanism of bone growth in different structures was revealed by in vivo experiments combined with CFD, providing a new theoretical basis for the design of bone scaffolds in the future.

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Mechanical Properties and Osteoconductivity of Porous Bioactive Titanium Metal

Key Engineering Materials ◽

10.4028/www.scientific.net/kem.284-286.263 ◽

2005 ◽

Vol 284-286 ◽

pp. 263-266 ◽

Cited By ~ 1

Author(s):

Mitsuru Takemoto ◽

Shunsuke Fujibayashi ◽

Tomiharu Matsushita ◽

J. Suzuki ◽

Tadashi Kokubo ◽

...

Keyword(s):

Bending Strength ◽

Bone Ingrowth ◽

Titanium Implant ◽

Porous Titanium ◽

Clinical Applications ◽

Tissue Response ◽

Titanium Metal ◽

Bending Properties ◽

Spray Method

Porous bioactive titanium implant was produced by plasma-spray method and succeeding chemical and thermal treatment. This porous titanium implant possess a porosity of 40% and complex interconnective porous structure. Mechanical property of porous titanium was characterized for compressive and 4-point bending properties, as well as compressive fatigue. Bone tissue response and biocompatibility of porous bioactive titanium implant was evaluated by in vivo osteoconductive model. Ultimate compression strength and bending strength were 280 and 101 MPa. Bone ingrowth showed significant increases in treated implant, while in these untreated porous titanium implant, bone ingrowth seemed to decrease with time. These results suggest that porous bioactive titanium is a candidate for clinical applications under load-bearing conditions.

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Patient-Specific 3-Dimensional Printing Titanium Implant Biomechanical Evaluation for Complex Distal Femoral Open Fracture Reconstruction with Segmental Large Bone Defect: A Nonlinear Finite Element Analysis

Applied Sciences ◽

10.3390/app10124098 ◽

2020 ◽

Vol 10 (12) ◽

pp. 4098

Author(s):

Kin Weng Wong ◽

Chung Da Wu ◽

Chi-Sheng Chien ◽

Cheng-Wei Lee ◽

Tai-Hua Yang ◽

...

Keyword(s):

Fracture Healing ◽

Postoperative Period ◽

Bone Grafting ◽

Locking Plate ◽

Bone Ingrowth ◽

Titanium Implant ◽

Patient Specific ◽

Large Defect ◽

Plate Removal ◽

Lightweight Structure

This study proposes a novel titanium 3D printing patient-specific implant: a lightweight structure with enough biomechanical strength for a distal femur fracture with segmental large defect using nonlinear finite element (FE) analysis. CT scanning images were processed to identify the size and shape of a large bone defect in the right distal femur of a young patient. A novel titanium implant was designed with a proximal cylinder tube for increasing mechanical stability, proximal/distal shells for increasing bone ingrowth contact areas, and lattice mesh at the outer surface to provide space for morselized cancellous bone grafting. The implant was fixed by transverse screws at the proximal/distal host bone. A pre-contoured locking plate was applied at the lateral site to secure the whole construct. A FE model with nonlinear contact element implant-bone interfaces was constructed to perform simulations for three clinical stages under single leg standing load conditions. The three stages were the initial postoperative period, fracture healing, and post fracture healing and locking plate removal. The results showed that the maximum implant von Mises stress reached 1318 MPa at the sharp angles of the outer mesh structure, exceeding the titanium destruction value (1000 MPa) and requiring round mesh angles to decrease the stress in the initial postoperative period. Bone stress values were found decreasing all the way from the postoperative period to fracture healing and locking plate removal. The overall construct deformation value reached 4.8 mm in the postoperative period, 2.5 mm with fracture healing assisted by the locking plate, and 2.1 mm after locking plate removal. The strain value at the proximal/distal implant-bone interfaces were valuable in inducing bone grafting in the initial postoperative period. The proposed patient-specific 3D printed implant is biomechanically stable for treating distal femoral fractures with large defect. It provides excellent lightweight structure, proximal/distal bone ingrowth contact areas, and implant rounded outer lattice mesh for morselized cancellous bone grafting.

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Experimental Biointegration of a Titanium Implant in Delayed Mandibular Reconstruction

Journal of Personalized Medicine ◽

10.3390/jpm10010006 ◽

2020 ◽

Vol 10 (1) ◽

pp. 6 ◽

Cited By ~ 1

Author(s):

Alexander Dolgolev ◽

Igor Reshetov ◽

Dmitry Svyatoslavov ◽

Mikhail Sinelnikov ◽

Konstantin Kudrin ◽

...

Keyword(s):

Bone Matrix ◽

Titanium Implant ◽

Titanium Implants ◽

Mandibular Reconstruction ◽

Histological Evaluation ◽

Plastic Plate ◽

Extensive Resection ◽

Bone Integration ◽

Variable Integration

Background: Mandibular reconstruction, after extensive resection of the mandible for the treatment of oral cancer, is a well-known procedure, however, relatively little is known about bone integration into the titanium implant after reconstruction with a temporary plastic implant. The main goal of this experimental study was to study the process of osseous integration into the titanium implant in an in vivo experiment following prior mandibular reconstruction with a temporary plastic implant. Materials and Methods: Four ewes initially underwent a partial one-sided resection of the mandible, with the formation of an approximately 3 × 1 cm defect. All of the subjects received reconstruction with an implantation of a plastic plate (3 cm). The plastic plate was removed and replaced by a titanium implant at 1, 3, 6, and 12 months, accordingly. Both plastic and titanium implants were made via 3D-printing technology and personalized modeling. A total of 6 months after titanium implantation, a histological evaluation of biointegration was performed. Results: All surgeries were uncomplicated. The integration of osseous tissue into the titanium implant was seen in all cases. Histologically, each case showed variable integration of dense fibrotic tissue with fibroblasts and non-mature bone tissue with a definitive layer of bone matrix with many osteoblasts on the periphery. The prior implantation of the plastic plate did not interfere with bone integration into the titanium implant. Conclusion: Preliminary results demonstrated that a temporary plastic implant for mandibular reconstruction does not interfere with the consequent osseous biointegration of a permanent titanium implant. This shows that temporary reconstruction is a safe solution when delayed mandibular reconstruction is required due to disease severity.

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Long-Term Study of Osteoconductivity of Bioactive Porous Titanium Metals: Effect of Sodium Removal by Dilute HCl Treatment

Key Engineering Materials ◽

10.4028/www.scientific.net/kem.396-398.353 ◽

2008 ◽

Vol 396-398 ◽

pp. 353-356 ◽

Cited By ~ 7

Author(s):

Kojiro Tanaka ◽

Mitsuru Takemoto ◽

Shunsuke Fujibayashi ◽

Keiichi Kawanabe ◽

Tomiharu Matsushita ◽

...

Keyword(s):

Heat Treatment ◽

Bone Ingrowth ◽

Titanium Implant ◽

Sodium Titanate ◽

Porous Titanium ◽

Hot Water ◽

Sodium Removal ◽

Long Term Study ◽

Free Treatment

In a previous study, we have reported that sodium removal by dilute hydrochloric acid (HCl) converted the sodium titanate layer on the surface of an alkali-treated porous titanium into titania with a specific structure that has better bioactivity than sodium titanate. We have shown that a porous titanium with this treatment have good osteoinductivity in soft tissue of canines. In the present study, we investigated the effect of this treatment on the osteoconductive abilities of porous bioactive titanium implant in the long term. Three types of surface treatments were applied: (a) no treatment , (b) alkali, hot water, and heat treatment ( conventional treatment: W-AH treatment), and (c) alkali, dilute HCl, hot water, and heat treatment (Na-free treatment: HCl-AH treatment). We then examined the osteoconductivity of the materials implanted in the femoral condyles of Japanese white rabbits at 6, 12, 26, and 52 weeks. The results showed that the bone ingrowth in HCl-AH porous bioactive titanium was significantly higher than in W-AH porous bioactive titanium at 52 weeks. Therefore, sodium removal has a positive effect on the osteoconductivity of the porous bioactive titanium implant in the long term.

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Formation and In Vitro and In Vivo Evaluation of Surface Modified Implants by HAp, Carbonated-HAp and Titanium Oxide

Materials Science Forum ◽

10.4028/www.scientific.net/msf.539-543.687 ◽

2007 ◽

Vol 539-543 ◽

pp. 687-691 ◽

Cited By ~ 1

Author(s):

Masazumi Okido ◽

Ryoichi Ichino ◽

Kotaro Kuroda

Keyword(s):

Titanium Oxide ◽

Titanium Implant ◽

Titanium Implants ◽

Contact Ratio ◽

In Vivo Evaluation ◽

Ft Ir ◽

Mouse Osteoblast ◽

Surface Modified

Hydroxyapatite (Ca10(PO4)6(OH)2, HAp), carbonated HAp and titanium oxide are of interest for bone-interfacing implant applications, because of their demonstrated osteoconductive properties. They were coated on the titanium implants and investigated the in vitro and in vivo performance. HAp coatings were performed by the thermal substrate method in aqueous solutions. Titanium oxide film was also formed on the titanium implants by gaseous oxidation, or by anodizing in the acidic solution. All the specimens covered with HAp, carbonated HAp or TiO2 (rutile or anatase). were characterized by XRD, EDX, FT-IR and SEM. In the in vitro testing, the mouse osteoblast-like cells (MC3T3-E1) were cultured on the coated and non-coated specimens for up to 30 days. Moreover, the osseointegration was evaluated from the rod specimens implanted in rats femoral for up to 8 weeks. In in vivo evaluations two weeks postimplantation, new bone formed on the coated and non-coated titanium rods in the cancellous bone and cortical bone, respectively. Bone-implant contact ratio, in order to evaluate of new bone formation, was significantly depended on the compound formed on the titanium implant.

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