The influence of bone formation on anchoring percutaneous devices with titanium fibre mesh flanges

For man-made percutaneous devices (PD), it is known that anchoring will improve the clinical success. Previously, our Department has designed PDs that use a sheet of titanium (Ti) fibre mesh for anchoring. In nature, a very successful natural PD occurs, namely the tooth. Teeth are anchored in the alveolar bone. In the current study, we evaluated whether a sheet of (ectopic) bone can be made, and be used to anchor a skin-penetrating device. Using available tissue engineering techniques, sheets of Ti fibre mesh were loaded with osteoblast-like cells. These sheets, and non-loaded controls, were placed subcutaneously in 20 syngeneic rats. After four weeks 10 rats were sacrificed, and tissues were prepared for histology. On the other 10 rats, a percutaneous Ti bar was screwed. These rats were evaluated clinically up to eight weeks. Finally, also their tissues were prepared for histology. The results showed, that bone formation was only established in one cell-loaded implant, of the four-week group. Clinical evaluation, and the histomorphometrical data, showed no differences between cell-loaded and unloaded samples. We concluded that the combination of Ti mesh with rat bone marrow cells was not able to generate bone formation after subcutaneous implantation predictably. Thus, our original aim could not be met. On the other hand, our results did confirm the biocompatible behaviour of a PD equipped with a Ti fibre mesh anchoring flange.