On the osseointegration of zirconia and titanium implants installed at defect site filled with xenograft material

Sung-Won Kim; In-Ho Cho

doi:10.4047/jkap.2014.52.1.9

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Kim and Cho: On the osseointegration of zirconia and titanium implants installed at defect site filled with xenograft material

ORIGINAL ARTICLE

J Korean Acad Prosthodont 2014;52(1):9-17.

Published online: NaN January 2014

DOI: https://doi.org/10.4047/jkap.2014.52.1.9

On the osseointegration of zirconia and titanium implants installed at defect site filled with xenograft material

Sung-Won Kim, In-Ho Cho^∗,

Department of Prosthodontics, College of Dentistry, Dankook University, Cheonan, Korea

∗Corresponding Author: In-Ho Cho Department of Prosthodontics, College of Dentistry, Dankook University 119, Dandae-ro, Dongnam-gu, Cheonan-si, Chungcheongnam-do, 330-714, Republic of Korea +82 41 550 1971: e-mail, cho8511@dankook.ac.kr

Received 25 October 201314 November 2013 Accepted 3 January 2014

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

Purpose

The purpose of this study was to compare zirconia implants with titanium implants from the view point of biomechanical stability and histologic response on osseoin-tegration when those were placed with xenograft materials.

Materials and methods

Specimens were divided into two groups; the control group was experimented with eighteen titanium implants which had anodized surface and the experimental group was experimented with eighteen sandblasted zirconia (Y-TZP) implants. At the tibias of six pigs, implants were installed into bone defect sites prepared surgically and treated with resorbable membranes and bovine bone. Two pigs were sacrificed after 1, 4 and 12 weeks respectively. Each implant site was sampled and processed for histologic and histomorphometric analysis. The stability of implants was evaluated with a Periotest^®. And the interfaces between bone and the implant were observed with a scanning electron microscope.

Results

In stability analysis there was no significant difference between Periotest values of the control group and the experimental group. In histologic analysis with a light microscope after 4 weeks, there was new bone formation with the resorption of bovine bone and the active synthesis of osteoblasts in both groups. In bone-implant contact percentage there was significant difference between both groups (P<.05). In bone area percentage there was no significant difference between both groups. In analysis of both groups with a scanning electron microscope there was a gap between bone and a surface at 4 weeks and it was filled up with bone formed newly at 12 weeks.

Conclusion

When accompanied by xenograft using membrane, bone to implant contact percentage of zirconia implants used in this experiment was significantly less than that of the titanium implants by surface treatment of anodic oxidation. So, it is considered that the improvement of zirconia implant is needed through ongoing research on surface treatment methods for its practical use. (J Korean Acad Prosthodont 2014;52:9-17)

Keywords: Zirconia, Xenograft, Bone to implant contact percentage, Bone area percentage

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Fig. 1.

Pictures of the titanium (A) and the zirconia (B) implant.

Fig. 2.

Surgically prepared bone defect site.

Fig. 3.

Implants placed with xenograft material.

Fig. 4.

Schematic drawing of the titanium implant at the bone defect site filled with bovine bone. The zirconia implant was installed in the same manner without placing the healing abutment.

Fig. 5.

A light micrograph of the control group taken 1 week after insertion of the implant (H-E staining; ×200). Bovine bone particles (arrow) were observed on the periphery of the threads.

Fig. 6.

A light micrograph of the control group taken 4 weeks after insertion of the implant (H-E staining; ×200). Osteoclasts (OC), osteoblasts (OB), osteoid (OS).

Fig. 7.

A light micrograph of the experimental group taken 4 weeks after insertion of the implant (H-E staining; ×100) A lattice of newly formed bone was approaching the implant from the bone.

Fig. 8.

A light micrograph of the control group taken 12 weeks after insertion of the implant (H-E staining; ×100). Scattered osteocytes were surrounded by the mineralized bone matrix. Remodelling was evident by formation of Harversian systems.

Fig. 9.

A light micrograph of the experimental group taken 12 weeks after insertion of the implant (H-E staining; ×100). In this specimen there were only minor signs of bone remodelling.

Fig. 10.

Bone to implant contact percentage of each group. ∗ represents significant difference between groups (P<.05).

Fig. 11.

Bone area percentage of each group.

Fig. 12.

Scanning electron micrographs of the implant surface (×10,000). A: The rough surface with regular sized pores on titanium. B: The surface with amorphous irregular crystal microstructure on zirconia.

Fig. 13.

Scanning electron micrographs of the interface between bone and implant surface at 12 weeks (A: control group, ×10,000, B: experimental group, ×2,000). A: collagen fiber (CF), titanium implant (Ti), bone (B), B: zirconia implant (Zr).

Table 1.

Classification of control and experimental groups

Group	Material	Surface preparation	Surface roughness (Ra)	Weeks	Number
Control	Titanium (grade IV)	Anodic oxidation with Mg ion	0.70 ㎛	1	6
				4	6
				12	6
Experimental	3Y-TZP	Sandblasting with Al2O3	0.29 ㎛	1	6
				4	6
				12	6

∗ 3Y-TZP: 3% mol yttrium-stabilized tetragonal zirconia polycrystal.

Table 2.

The mean and standard deviation of Periotest value

	1 week group		4 weeks group		12 weeks group
	0 week	1 week	0 week	4 weeks	0 week	12 weeks
Control	9.7 ± 8.6	0.7 ± 3.1	5.3 ± 6.6	-4.7 ± 2.1	0.3 ± 5.1	-5.6 ± 2.3
Experimental	2.8 ± 3.5	0.8 ± 2.2	2.5 ± 5.3	-4.5 ± 1.1	1.1 ± 2.2	-3.3 ± 2.7

Table 3.

The mean and standard deviation of bone to implant contact percentage

	Bone to implant contact (%)
	1 week	4 week	12 week
Control group	0.54 ± 0.66	22.79 ± 8.12	54.96 ± 29.69
Experimental group	1.45 ± 1.70	5.24 ± 5.81	10.72 ± 13.28

Table 4.

The mean and standard deviation of bone area percentage

	Bone area (%)
	1 week	4 week	12 week
Control group	0.66 ± 1.76	28.01 ± 16.98	48.39 ± 21.19
Experimental group	3.04 ± 3.77	13.83 ± 11.61	42.32 ± 8.07

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