Biomechanical and histological evaluation of the osseointegration capacity of two types of zirconia implant

The purpose of this study was to evaluate the biomechanical and histological behavior of a ceria-stabilized zirconia–alumina nanocomposite (NanoZr) in comparison with that of 3 mol% yttria-stabilized tetragonal zirconia polycrystalline (3Y-TZP) in Sprague Dawley rats. Cylindrical NanoZr and 3Y-TZP implants (diameter 1 mm, length 2 mm) were used. Implant-surface morphology and surface roughness were determined by scanning white-light interferometry and scanning electron microscopy, respectively. The cylindrical zirconia implants were placed at the distal edge of the femur of Sprague Dawley rats. At weeks 2, 4, and 8, the interfacial shear strength between implant and bone was measured by push-in test. Histological analysis was performed using hard-tissue sections. Bone–implant contact (BIC), the thickness of new bone around the implant within the bone marrow area, and osteoclast numbers were evaluated. The average surface roughness of 3Y-TZP (Sa 0.788 μm) was significantly higher than that of NanoZr (Sa 0.559 μm). The shear strengths of 3Y-TZP and NanoZr were similar at 2 weeks, but at 4 and 8 weeks the shear strength of NanoZr was higher than that of 3Y-TZP. The average BIC values within the bone marrow area for 3Y-TZP and NanoZr were 25.26% and 31.51% at 2 weeks, 46.78% and 38% at 4 weeks, and 47.88% and 56.81% at 8 weeks, respectively. The average BIC values within the cortical area were 38.86% and 58.42% at 2 weeks, 66.82% and 57.74% at 4 weeks, and 79.91% and 78.97% at 8 weeks, respectively. The mean BIC value did not differ significantly between the two zirconia materials at any time point. The NanoZr implants were biocompatible, capable of establishing close BIC, and may be preferred for metal-free dental implants.

[1]  J. Jansen,et al.  Effects of implant surface coatings and composition on bone integration: a systematic review. , 2009, Clinical oral implants research.

[2]  J. Hobkirk,et al.  Ceramics in implant dentistry (Working Group 1). , 2009, Clinical oral implants research.

[3]  G. le Naour,et al.  Evaluation of combinations of titanium, zirconia, and alumina implants with 2 bone fillers in the dog. , 1999, The International journal of oral & maxillofacial implants.

[4]  S. Milz,et al.  In vivo performance of zirconia and titanium implants: a histomorphometric study in mini pig maxillae. , 2012, Clinical oral implants research.

[5]  T. Nakamura,et al.  Bone remodeling around implanted ceramics. , 1996, Journal of biomedical materials research.

[6]  Ming Zhou,et al.  MC3T3-E1 cell response to stainless steel 316L with different surface treatments. , 2015, Materials science & engineering. C, Materials for biological applications.

[7]  M. Swain,et al.  Ceramic implants (Y-TZP): are they a viable alternative to titanium implants for the support of overdentures? A randomized clinical trial. , 2014, Clinical oral implants research.

[8]  Seiji Ban,et al.  Effect of surface roughness on initial responses of osteoblast-like cells on two types of zirconia. , 2009, Dental materials journal.

[9]  E. Steinhauser,et al.  Failure analysis of fractured dental zirconia implants. , 2012, Clinical oral implants research.

[10]  Seiji Ban,et al.  Reliability and properties of core materials for all-ceramic dental restorations , 2008 .

[11]  C. Sukotjo,et al.  Biomechanical Evaluation of Osseous Implants Having Different Surface Topographies in Rats , 2000, Journal of dental research.

[12]  Guang Hong,et al.  The surface characterization and bioactivity of NANOZR in vitro. , 2014, Dental materials journal.

[13]  R. Haas,et al.  Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score. , 2005, Clinical oral implants research.

[14]  P. Hanes,et al.  Osteogenesis at the dental implant interface: high-voltage electron microscopic and conventional transmission electron microscopic observations. , 1993, Journal of biomedical materials research.

[15]  J. Rodrigo,et al.  Immune Response to Synthetic Materials: Sensitization of Patients Receiving Orthopaedic Implants , 1996, Clinical orthopaedics and related research.

[16]  A. Sicilia,et al.  Titanium allergy in dental implant patients: a clinical study on 1500 consecutive patients. , 2008, Clinical oral implants research.

[17]  J. Radford.  Suspected association of an allergic reaction with titanium dental implants: a clinical report , 2009, BDJ.

[18]  Y Zilberman,et al.  Osseous adaptation to continuous loading of rigid endosseous implants. , 1984, American journal of orthodontics.

[19]  S. Volinia,et al.  Zirconium oxide: analysis of MG63 osteoblast-like cell response by means of a microarray technology. , 2004, Biomaterials.

[20]  Y. Sato,et al.  Comparison between freestanding and tooth-connected partially stabilized zirconia implants after two years' function in monkeys: a clinical and histologic study. , 1998, The Journal of prosthetic dentistry.

[21]  S. Milz,et al.  Osseointegration of zirconia and titanium dental implants: a histological and histomorphometrical study in the maxilla of pigs. , 2009, Clinical oral implants research.

[22]  Marina Andreiotelli,et al.  Are ceramic implants a viable alternative to titanium implants? A systematic literature review. , 2009, Clinical oral implants research.

[23]  J. D. Da Silva,et al.  Optical phenomenon of peri-implant soft tissue. Part I. Spectrophotometric assessment of natural tooth gingiva and peri-implant mucosa. , 2007, Clinical oral implants research.

[24]  Irena Sailer,et al.  In vitro color changes of soft tissues caused by restorative materials. , 2007, The International journal of periodontics & restorative dentistry.

[25]  E. Machtei,et al.  Fracture of Dental Implants: Literature Review and Report of a Case , 2002, Implant dentistry.

[26]  R. Kohal,et al.  Fracture strength of zirconia implants after artificial aging. , 2009, Clinical implant dentistry and related research.

[27]  M. Yoshinari,et al.  Response of osteoblast-like cells to zirconia with different surface topography. , 2013, Dental materials journal.

[28]  T. Tanaka,et al.  Light and electron microscopic studies of bone-titanium interface in the tibiae of young and mature rats. , 1996, Journal of biomedical materials research.

[29]  C. Minkin,et al.  Role of the Osteoclast at the Bone-Implant Interface , 1999, Advances in dental research.

[30]  M. Yoshinari,et al.  Fatigue Strength of Ce-TZP/Al2O3 Nanocomposite with Different Surfaces , 2012, Journal of dental research.

[31]  T. Webster,et al.  Enhanced functions of osteoblasts on nanophase ceramics. , 2000, Biomaterials.

[32]  M. Wolkewitz,et al.  Biomechanical and histological behavior of zirconia implants: an experiment in the rat. , 2009, Clinical oral implants research.

[33]  R. Kohal,et al.  Evaluation of alumina toughened zirconia implants with a sintered, moderately rough surface: An experiment in the rat. , 2016, Dental materials : official publication of the Academy of Dental Materials.

[34]  K. Müller,et al.  Hypersensitivity to titanium: clinical and laboratory evidence. , 2006, Neuro endocrinology letters.

[35]  L. Sennerby,et al.  Bone tissue responses to surface-modified zirconia implants: A histomorphometric and removal torque study in the rabbit. , 2005, Clinical implant dentistry and related research.

[36]  Richard Skalak,et al.  The interface zone of inorganic implantsIn vivo: Titanium implants in bone , 2006, Annals of Biomedical Engineering.

[37]  T. Webster,et al.  Osteoblast adhesion on nanophase ceramics. , 1999, Biomaterials.

[38]  Tohru Sekino,et al.  Tough and strong Ce-TZP/Alumina nanocomposites doped with titania , 1998 .

[39]  A. Jahn-Eimermacher,et al.  Osseointegration of one-piece zirconia implants compared with a titanium implant of identical design: a histomorphometric study in the dog. , 2010, Clinical oral implants research.

[40]  Lars Sennerby,et al.  Early tissue response to titanium implants inserted in rabbit cortical bone , 1993 .

[41]  S. Eichhorn,et al.  Biomechanical and histomorphometric comparison between zirconia implants with varying surface textures and a titanium implant in the maxilla of miniature pigs. , 2007, Clinical oral implants research.

[42]  Young-Seok Park,et al.  Peri-implant bone formation and surface characteristics of rough surface zirconia implants manufactured by powder injection molding technique in rabbit tibiae. , 2013, Clinical oral implants research.

[43]  H. Schliephake,et al.  Mechanical anchorage and peri-implant bone formation of surface-modified zirconia in minipigs. , 2010, Journal of clinical periodontology.