A histomorphometric study on the effect of surface treatment on the osseointegration

Woong-Jae Choi; In-Ho Cho

doi:10.4047/jkap.2009.47.4.445

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Choi and Cho: A histomorphometric study on the effect of surface treatment on the osseointegration

ORIGINAL ARTICLE

J Korean Acad Prosthodont 2009;47(4):445-456.

Published online: 18 December 2009

DOI: https://doi.org/10.4047/jkap.2009.47.4.445

A histomorphometric study on the effect of surface treatment on the osseointegration

Woong-Jae Choi, DDS, MSD¹, In-Ho Cho, DDS, MSD, PhD^2,^∗

^¹Graduate Student, Department of Prosthodontics, College of Dentistry, Dankook University

^²Professor, Department of Prosthodontics, College of Dentistry, Dankook University

∗Corresponding Author: In-Ho Cho Department of Prosthodontics, College of Dentistry, Dankook University San 7-1, Shinboo-Dong, Cheonan, Choongnam, 330-716, Korea +82 41 550 1971: e-mail, cho8511@dku.edu

Received 4 September 200913 October 2009 Accepted 14 October 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Statement of problem

Many studies have been conducted to improve the primary stability of implants by providing bioactive surfaces via surface treatments. Increase of surface roughness may increase osteoblast activity and promote stronger bonding between bone and implant surface and it has been reported that bioactive surface or titanium can be obtained through alkali and heat treatment.

Purpose

The purpose of this study was to evaluate the stability of alkali and heat treated implants via histomorphometric analysis.

Material and methods

Specimens were divided into three groups; group 1 was the control group with machined surface, the other groups were treated for 24 hours in 5 M NaOH solution and heat treated for 1 hour at 600℃ in the atmosphere (group 2) and vacuum (group 3) conditions respectively. Surface characteristics were analyzed and fixtures were implanted into rabbits. The specimens were histologically and histomorphometrically compared according to healing periods and change in bone composition were analyzed with EPMA (Electron Probe Micro Analyzer).

Results

1. Groups treated with alkali and heat showed increase of oxidization layer and Na ions. Groups 2 which was heat treated in atmosphere showed significant increase of surface roughness (P < .05). 2. Histomorphometric analysis showed significant increase in BIC (bone to implant contact) according to increase in healing period and there was significant increases in groups 2 and 3 (P < .05). 3. BA(bone area) ratio showed similar results as contact ratio, but according to statistical analysis there was significant increase according to increase in healing period in group 2 only (P < .05). 4. EPMA analysis revealed no difference in gradation of bone composition of K, P, Ca, Ti in surrounding bone of implants according to healing periods but groups 2 and 3 showed increase of Ca and P in the initial stages.

Conclusion

From the results above, it can be considered that alkali and heat treated implants in the atmosphere have advantages in osseointegration in early stages and may decrease the time interval between implantation and functional adaptation. (J Korean Acad Prosthodont 2009;47:445-56)

Keywords: Titanium implant, Alkali and heat treatment, Osseointegration

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Fig. 1.

Example of EPMA mapping result. I: implant, B: bone (K: upper left, P: upper right, Ca: lower left, Ti: lower right).

Fig 2.

3D reconstruction result of EPMA (Electron Probe Micro Analyzer) data of Ca at 6 week.

Fig. 3.

Line analysis result of EPMA (Electron Probe Micro Analyzer) data of Ca at 6 week.

Fig. 4.

FESEM (Field Emition Scanning Electron Microscope) findings of implant surface. Group 1: Machined, Group 2: Treated with alkali and heat in atmosphere, Group 3: Treated with alkali and heat in vacuum.

Fig. 5.

3D (Dimension) Result of AFM (Atomic Force Microscope) scanning. Group 1: Machined, Group 2: Treated with alkali and heat in atmosphere, Group 3: Treated with alkali and heat in vacuum.

Fig. 6.

BIC (Bone to Implant Contact) and BA (Bone Area) measuring at 2 weeks. Group 1: Machined, Group 2: Treated with alkali and heat in atmosphere, Group 3: Treated with alkali and heat in vacuum.

Fig. 7.

BIC (Bone to Implant Contact) and BA (Bone Area) measuring at 4 weeks. Group 1: Machined, Group 2: Treated with alkali and heat in atmosphere, Group 3: Treated with alkali and heat in vacuum.

Fig. 8.

BIC (Bone to Implant Contact) and BA (Bone Area) measuring at 6 weeks. Group 1: Machined, Group 2: Treated with alkali and heat in atmosphere, Group 3: Treated with alkali and heat in vacuum.

Fig. 9.

BIC (Bone to Implant Contact) and BA (Bone Area) measuring at 8 weeks. Group 1: Machined, Group 2: Treated with alkali and heat in atmosphere, Group 3: Treated with alkali and heat in vacuum.

Fig. 10.

BIC (Bone to Implant Contact) and BA (Bone Area) measuring at 12 weeks. Group 1: Machined, Group 2: Treated with alkali and heat in atmosphere, Group 3: Treated with alkali and heat in vacuum.

Table I.

Surface treatment of each groups

Group	Preparation	N
1	Machined	40
2	5M Alkali (24 H) + 600℃ heat treatment (1 H) in atmosphere	40
3	5M Alkali (24H) + 600℃ heat treatment (1 H) in vacuum	40

Table II.

Surface roughness of implant measured with AFM unit: μ m

Surface		Mean	SD
Group 1	Sa Sq	0.10∗ 0.13∗∗	0.009 0.013
Group 2	Sa Sq	0.24∗ 0.30∗∗	0.080 0.094
Group 3	Sa Sq	0.17 0.22	0.022 0.031

Group 1 : Machined, Group 2 : Treated with alkali and heat in atmosphere, Group 3 : Treated with alkali and heat in vacuum. (P < .05)

^∗ : denotes significant difference between groups at 0.05 level

^∗∗ : denotes significant difference between groups at 0.05 level

Table III.

The mean and standard deviation of bone to implant contact

BIC	2 week	4 week	6 week	8 week	12 week
Group 1	0.54 ± 0.40	0.60 ± 0.36	0.58 ± 0.35	0.67 ± 0.25	0.72 ± 0.44
Group 2	0.59 ± 0.36	0.86 ± 0.22	0.89 ± 0.11	0.75 ± 0.24	0.85 ± 0.18
Group 3	0.46 ± 0.28	0.80 ± 0.18	0.65 ± 0.15	0.71 ± 0.21	0.84 ± 0.15

Group 1 : Machined, Group 2 : Treated with alkali and heat in atmosphere, Group 3 : Treated with alkali and heat in vacuum.

Table IV.

Results of multiple range test for BIC ratio of Group 2 (Duncan test)

2 week (0.59 ± 0.36)	4 week (0.86 ± 0.22)	6 week (0.89 ± 0.11)	8 week (0.75 ± 0.24)	12 week (0.85 ± 0.18)
2 week	∗	∗	∗	∗
4 week
6 week
8 week
12 week

Group 2 : Treated with alkali and heat in atmosphere.

Table V.

Results of multiple range test for BIC ratio of Group 3 (Duncan test)

2 week (0.46 ± 0.28)	4 week (0.80 ± 0.18)	6 week (0.65 ± 0.15)	8 week (0.71 ± 0.21)	12 week (0.84 ± 0.15)
2 week	∗		∗	∗
4 week		∗
6 week
8 week
12 week

Group 3 : Treated with alkali and heat in vacuum.

Table VI.

The mean and standard deviation of bone area

BIC	2 week	4 week	6 week	8 week	12 week
Group 1	0.51 ± 0.37	0.56 ± 0.35	0.75 ± 0.22	0.69 ± 0.21	0.74 ± 0.38
Group 2	0.64 ± 0.19	0.66 ± 0.20	0.81 ± 0.14	0.78 ± 0.14	0.82 ± 0.16
Group 3	0.61 ± 0.36	0.62 ± 0.34	0.79 ± 0.25	0.76 ± 0.19	0.80 ± 0.17

Group 1 : Machined, Group 2 : Treated with alkali and heat in atmosphere, Group 3 : Treated with alkali and heat in vacuum.

Table VII.

Results of multiple range test for BA ratio of Group 2 (Duncan test)

2 week (0.64 ± 0.19)	6 week (0.81 ± 0.14)	12 week (0.82 ± 0.16)
2 week	∗	∗
4 week	∗	∗
6 week
8 week
12 week

Group 2 : Treated with alkali and heat in atmosphere.

Table VIII.

Mean and standard deviation of each element intensity

		2 week		4 week		6 week		8 week		12 week
		Mean	SD	Mean	SD	Mean	SD	Mean	SD	Mean	SD
	Group 1	23.20	2.39	23.00	2.24	24.20	3.27	23.20	1.10	24.40	1.14
K	Group 2	23.80	3.19	23.80	2.39	26.00	1.58	23.80	3.19	24.80	3.63
	Group 3	26.20	4.49	27.00	3.54	24.80	5.07	27.20	3.96	27.60	6.23
	Group 1	122.00	10.51	130.00	11.02	129.80	8.84	130.20	8.32	122.20	6.69
P	Group 2	125.80	10.78	132.00	6.96	151.80	8.70	125.40	10.43	134.60	6.66
	Group 3	123.00	8.22	150.20	10.76	129.60	16.32	150.60	10.16	137.80	5.63
	Group 1	2452.80	160.07	3039.40	33.52	3251.80	246.54	3037.40	472.20	3067.00	453.31
Ca	Group 2	2604.00	286.00	3187.20	247.52	3132.20	237.16	2615.40	308.70	3101.60	134.33
	Group 3	3318.60	202.03	3133.40	239.83	2705.00	496.67	3112.80	194.09	3025.20	431.38
	Group 1	3653.40	108.28	3351.40	198.36	3436.40	220.00	3329.40	210.52	3531.20	318.27
Ti	Group 2	3544.20	87.16	3246.00	192.68	3299.80	145.35	3437.00	107.26	3165.60	406.24
	Group 3	3653.40	108.28	3329.40	210.52	3480.80	185.03	3329.40	210.52	3531.20	318.27

Table IX.

Results of multiple range test at 2 weeks for intensity of Ca (Duncan test)

	Group 2	Group 3
Group 1 (2452.80 ± 160.07)	∗	∗
Group 2 (2604.00 ± 286.00)		∗
Group 3 (3318.60 ± 202.03)

Table X.

Results of multiple range test at 4 weeks for intensity of P

Duncan test)
	Group 1	Group 2	Group 3
Group 1 (130.00 ± 11.02)		∗	∗
Group 2 (132.00 ± 6.96)			∗
Group 3 (150.20 ± 10.76)

Table XI.

Results of multiple range test at 6 weeks for intensity of P (Duncan test)

	Group 2	Group 3
Group 1 (129.80 ± 8.84)	∗
Group 2 (151.80 ± 8.70)		∗
Group 3 (129.60 ± 16.32)

Table XII.

Results of multiple range test at 8 weeks for intensity of P (Duncan test)

	Group 2	Group 3
Group 1 (130.20 ± 8.32)	∗	∗
Group 2 (125.40 ± 10.43)		∗
Group 3 (150.60 ± 10.16)

Table XIII.

Results of multiple range test at 12 weeks for intensity of P (Duncan test)

	Group 2	Group 3
Group 1 (122.20 ± 6.69)	∗	∗
Group 2 (134.60 ± 6.66)
Group 3 (137.80 ± 5.63)

Group 1 : Machined, Group 2 : Treated with alkali and heat in atmosphere, Group 3 : Treated with alkali and heat in vacuum.

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