Histological and Mechanical Analysis of Bone/Implant Interface in Female Retired-Breeder Rabbits

Abstract

Endosseous implants have been accepted as a viable dental and medical adjunct and are now used for multiple dental applications. The majority are placed in patients of relatively advanced age, and, as such, the increased use of implants has raised questions in the areas of bone healing and metabolism associated with their placement. This study evaluated the mechanical and histological aspects of the bone/metal interface of endosseous titanium implants in compact and trabecular bone. Two implants were placed: one in the distal metaphysis (M) and one 2.0 cm proximal in the diaphysis (D). Right side limbs were subjected to a sham surgery and served as controls. The rabbits were sacrificed at six, 12, and 24 weeks healing time. Multiple fluorochrome labels were given to mark sites of bone formation. At sacrifice, all implants were tested for interface torque strength. Microradiography and fluorescent light microscopy were used to determine percent volume of bone and marrow space, bone/implant interface characteristics, percent labeled bone surface area, and percent labeled bone volume. D implants required about 20 percent more torque to mechanically disrupt the bone/implant interface than M implants. Values were M (combined groups) 33.4 N-cm ±15.5 N-cm, and D (combined groups) 41.5 N-cm ±16.0 N-cm (Mean ±SD, n = 8, p<.07). The percent of bone in direct contact with the implant surface appeared to increase only slightly with time. Direct contact occurred on 11.2%, 9.5% ±8.5% and 13.9% ±6.6% of the M implant surface in six, 12, and 24 week specimens, respectively. Direct contact occured on 11.7%, 10.2% ±2.4% and 19.5% ±0.35% of the D implant surface in six, 12, and 24 week specimens, respectively. Total bone volume in implanted D specimens was less [Exp.= 91.1% ± 3.1%, Cont. = 95.5% ± 0.73% (Mean ±SD)] and marrow space volume was greater [Exp. = 8.9% ±3.02%, Cont. = 4.6% ±0.73% (Mean ±SD)] than in controls (p<.02). The percent labeled bone volume was greater in the implanted specimens than in their controls (p<.001). This difference decreased over time. Implanted D specimens also showed significantly more (p<.001) labeled bone surface area than controls. These findings suggest that when implants are placed in elderly subjects, normally inactive bone becomes very active. Also, it seems that bone quality, not quantity, determines interface strength.