Fibrovascularization and osteogenesis in high-density porous polyethylene implants

High-density porous polyethylene (HDPP) has been extensively used in craniofacial reconstructions with high-level success and minimal complications. It is known for its biocompatibility and satisfactory stability in the receptor bone area, presenting only a few reports of mobility and infection. In the current study, attention was given to the interface area between HDPP and bone surface to analyze fibrous and bone tissue formation and ingrowth into the pores of the material placed in the mandible of rabbits. Twelve male New Zealand rabbits underwent surgical procedure to receive bilateral HDPP implants in buccal face of dentate mandibular alveolar process, fixed with titanium screws. After 7, 14, 45, and 90 days, the animals were killed, and the specimens were retrieved for histologic and immunohistochemical analyses. No implant loss or infection was detected at the retrieval of the specimens. The microscopic analysis presented satisfactory integration of the material to the bone surface, with new bone formation from the receptor bed and inside the pores of the material, observed from the 15th day. After 90 days, remodeling bone and fibrous tissue was seen in the interface region. Among some of the pores, mature lamellar bone was present. Immunohistochemistry pointed out a moderate expression either to Core binding factor protein 1/RUNX2 or to vascular endothelial growth factor for early periods evaluated, that is, 7 and 15 days after surgery. These results confirm the osteoconductive behavior and high biocompatibility of the material, associated to its adequate immobilization, leading to its lifelong presence in human biologic system.