Osseointegration of Zirconium Dioxide Implants With Microrough Surface Topography Compared to Titanium Implants - A Histological Study on Sheep

Abstract

Introduction: Dental implantology has established as an important treatment method in dental, oral and maxillofacial medicine. In addition to aesthetic and functional rehabilitation, the main function of implant dentistry is the prevention of peri-implant bone resorption as the main cause of peri-implant inflammation. The aim of this sheep study was to investigate the bony healing of zirconium dioxide implants with a special microrough surface using our currently developed lower jaw sheep model. Material and Methods: As comparative samples were used titanium implants with acid-etched surfaces (OsteoActive®), which currently represent the “gold standard” in dental implantology used are showing in Figure 1. The qualitative surface examinations of the investigated ceramic implants (Carident AG™, Switzerland) were performed with scanning electron microscope in high vacuum combined with an EDX detector for elemental analysis of the sample surface. For the animal experiment 6 clinically healthy sheep (Stavropol Sheep) were used. The bone-to-implant interface was investigated by qualitative histological analyses using REM analysis and the Technovit 9100 New (PMMA) embedding method. In addition, a TRAP analysis was performed to evaluate the cellular peri-implant bone regeneration process. Results: The histological evaluation of peri-implant bone formation was based on PMMA sections stained with toluidine Blu and polarization-optical images. Using TRAP staining we evaluate the quality of cellular bone formation. Direct bone attachment to the implant surfaces was observed both in areas with trabecular bone components and along zones consisting mainly of bone marrow. Physiological bone remodeling around the inserted implants was observed in both trial groups in cortical areas without differences. This is also confirmed by the REM examinations performed in parallel. Conclusion: These results support the conclusion that zirconium di-oxide implants have a comparable Osseo integrative capacity as titanium implants with acid-etched surfaces.