Osseointegration of zirconia implants with different surface characteristics: an evaluation in rabbits.

PURPOSE Zirconia ceramics are a viable alternative to titanium for use as dental implants. However, the smooth surface of zirconia means that longer healing periods are needed to accomplish osseointegration compared to roughened titanium surfaces. Surface modifications can be used to increase the roughness of zirconia. The aim of this study was to assess histologically and compare the degree of early bone apposition around zirconia dental implants with sandblasted, sintered, or laser-modified surfaces to that seen around surface-modified titanium implants. Removal torque was also measured and compared. MATERIALS AND METHODS Ninety-six implants--24 each of four types (sintered zirconia, laser-modified zirconia, sandblasted zirconia, and acid-etched titanium)--were placed in 48 New Zealand White female rabbits. One implant was inserted in each distal femur. Half of the specimens were harvested at 6 or 12 weeks and processed for light microscopic analysis; the area of bone-to-implant contact was measured morphometrically. The other half were evaluated for removal torque at 6 and 12 weeks. RESULTS No statistically significant differences existed in bone apposition between the different surfaces at either time point. Differences in removal torque were significantly different between titanium and sandblasted zirconia and between sintered zirconia and sandblasted zirconia, with the first mentioned demonstrating a higher torque value at 6 weeks. At 12 weeks, the only significant difference in removal torque was between titanium and sandblasted zirconia, with titanium demonstrating the higher value. CONCLUSION Comparable rates of bone apposition in the zirconia and titanium implant surfaces at 6 and 12 weeks of healing were observed. Removal torque values were similar for all implants with a roughened surface.

[1]  D. Steflik,et al.  Ultrastructural comparisons of ceramic and titanium dental implants in vivo: a scanning electron microscopic study. , 1989, Journal of biomedical materials research.

[2]  I Ahmad,et al.  Yttrium-partially stabilized zirconium dioxide posts: an approach to restoring coronally compromised nonvital teeth. , 1998, The International journal of periodontics & restorative dentistry.

[3]  R. Jung,et al.  The zirconia implant-bone interface: a preliminary histologic evaluation in rabbits. , 2008, The International journal of oral & maxillofacial implants.

[4]  T Albrektsson,et al.  Osseointegration: current state of the art. , 1989, Dental clinics of North America.

[5]  Niklaus P Lang,et al.  De novo alveolar bone formation adjacent to endosseous implants. , 2003, Clinical oral implants research.

[6]  G. Mailath,et al.  Osseous healing characteristics of three different implant types. , 2003, Clinical oral implants research.

[7]  A. Weinstein,et al.  An evaluation of porous alumina ceramic dental implants. , 1980, Journal of Oral Implantology.

[8]  T. Albrektsson,et al.  Oral implant surfaces: Part 2--review focusing on clinical knowledge of different surfaces. , 2004, The International journal of prosthodontics.

[9]  T. Testori,et al.  A human histologic analysis of osseotite and machined surfaces using implants with 2 opposing surfaces. , 1999, The International journal of periodontics & restorative dentistry.

[10]  W E Roberts,et al.  Bone tissue interface. , 1988, Journal of dental education.

[11]  N. Kübler,et al.  Osseointegration of zirconia implants compared with titanium: an in vivo study , 2008, Head & face medicine.

[12]  C. Clokie,et al.  Development of a rat tibia model for morphological studies of the interface between bone and a titanium implant. , 1995, Compendium.

[13]  Ender Kazazoğlu,et al.  Zirconia dental implants: a literature review. , 2011, The Journal of oral implantology.

[14]  U. Hübner,et al.  Behavior of CAL72 osteoblast-like cells cultured on zirconia ceramics with different surface topographies. , 2007, Clinical oral implants research.

[15]  Tomas Albrektsson,et al.  Osseointegrated Oral implants , 1988 .

[16]  H. Tsuru,et al.  Interface histology of unloaded and early loaded partially stabilized zirconia endosseous implant in initial bone healing. , 1993, The Journal of prosthetic dentistry.

[17]  K. N. Pedersen Tissue reaction to submerged ceramic tooth root implants. An experimental study in monkeys. , 1979, Acta odontologica Scandinavica.

[18]  D. Martini,et al.  Influence of a zirconia sandblasting treated surface on peri-implant bone healing: An experimental study in sheep. , 2009, Acta biomaterialia.

[19]  N Freiberg,et al.  Osseointegrated oral implants. A Swedish multicenter study of 8139 consecutively inserted Nobelpharma implants. , 1988, Journal of periodontology.

[20]  C. de Putter,et al.  A Clinical, Radiographic, and Histological Evaluation of Permucosal Dental Implants of Dense Hydroxylapatite in Dogs , 1989, Journal of dental research.

[21]  S. Steinemann,et al.  Titanium deposition in regional lymph nodes after insertion of titanium screw implants in maxillofacial region. , 1994, International journal of oral and maxillofacial surgery.

[22]  G. Jordan,et al.  A study of titanium release into body organs following the insertion of single threaded screw implants into the mandibles of sheep. , 2002, Australian dental journal.

[23]  M. Spector,et al.  Porous titanium endosseous dental implants in Rhesus monkeys: microradiography and histological evaluation. , 1979, Journal of biomedical materials research.

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

[25]  藁科 秀紀 Biological reaction to alumina, zirconia, titanium and polyethylene particles implanted onto murine calvaria , 2004 .

[26]  R. Kohal,et al.  A zirconia implant-crown system: a case report. , 2004, The International journal of periodontics & restorative dentistry.

[27]  J. Ong,et al.  Deposition of highly adhesive ZrO(2) coating on Ti and CoCrMo implant materials using plasma spraying. , 2003, Biomaterials.

[28]  P. Branemark,et al.  Long-term follow-up study of osseointegrated implants in the treatment of totally edentulous jaws. , 1990, The International journal of oral & maxillofacial implants.

[29]  N. Lang,et al.  Early bone formation adjacent to rough and turned endosseous implant surfaces. An experimental study in the dog. , 2004, Clinical oral implants research.

[30]  P. Branemark,et al.  Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period. , 1977, Scandinavian journal of plastic and reconstructive surgery. Supplementum.

[31]  S. Ferguson,et al.  Biomechanical comparison of different surface modifications for dental implants. , 2008, The International journal of oral & maxillofacial implants.

[32]  A. Piattelli,et al.  Bone response to zirconia ceramic implants: an experimental study in rabbits. , 2003, The Journal of oral implantology.

[33]  R. Melrose,et al.  Histologic evaluation of vitreous carbon endosteal implants in dogs. , 1975, Biomaterials, medical devices, and artificial organs.

[34]  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.

[35]  R. Kohal,et al.  Loaded custom-made zirconia and titanium implants show similar osseointegration: an animal experiment. , 2004, Journal of periodontology.

[36]  P. Fielder,et al.  Implants: Bone physiology and metabolism. , 1987, CDA journal.

[37]  H Tsuru,et al.  Tissue compatibility and stability of a new zirconia ceramic in vivo. , 1992, The Journal of prosthetic dentistry.

[38]  R. Mckinney,et al.  The single crystal sapphire endosseous dental implant. II. Two-year results of clinical animal trials. , 1983, The Journal of oral implantology.

[39]  P. Schüpbach,et al.  Evaluation of nano-technology-modified zirconia oral implants: a study in rabbits. , 2009, Journal of clinical periodontology.

[40]  J. Mc Restoration of posterior implants using a new ceramic material. , 1999 .

[41]  A. Weinstein,et al.  Clinical, Radiographical, and Histological Evaluation of Porous Rooted Polymethylmethacrylate Dental Implants , 1979, Journal of dental research.