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Biological Compatibility Profile on Biomaterials for Bone Regeneration
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Biologic Bone Behavior During the Osseointegration Process: Histologic, Histomorphometric, and SEM-EDX Evaluations.

Filiberto Mastrangelo, Stefano Parma-Benfenati, Raimondo Quaresima

    The International Journal of Periodontics & Restorative Dentistry
    |January 20, 2023
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    Summary

    This study reveals osseointegration is a dynamic process. Bone quality maturation occurs "at distance" from the implant surface, not directly on it, indicating incomplete healing even after 90 days.

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    Area of Science:

    • Biomaterials Science
    • Orthopedic Research
    • Tissue Engineering

    Background:

    • Osseointegration is crucial for dental and orthopedic implants.
    • Understanding dynamic bone behavior during osseointegration is essential for predicting implant success.
    • Current knowledge on the temporal and spatial maturation of bone tissue around implants is limited.

    Purpose of the Study:

    • To evaluate bone behavior and quality during dynamic osseointegration in a sheep tibia model.
    • To quantitatively and qualitatively assess bone-implant contact, density, and mineralization over time.
    • To investigate the spatial distribution of bone maturation at different zones around the implant.

    Main Methods:

    • Histologic, histomorphometric, Alizarin Red S, and SEM-EDX analyses were performed on sheep tibia implants.
    • Bone samples were analyzed at 15, 30, 60, and 90 days post-implantation.
    • Dynamic Osseointegration Index (DOI), Bone Quality Index (BQI), and calcium/phosphorus (Ca/P) content were measured in specific zones.

    Main Results:

    • Early bone formation (15 days) showed low mineralization (low Ca/P, BIC 23.3%).
    • Significant new bone deposition occurred by 30 days (BIC 77.3%), with increasing maturation in zones B and C.
    • At 90 days, high BIC (86.4%) was observed, but the Bone Quality Index (BQI) was lower (25%) at the titanium-bone interface (zone A), indicating incomplete maturation.

    Conclusions:

    • Osseointegration is a dynamic process with initial high bone deposition followed by maturation.
    • Bone quality maturation, assessed by BQI and Ca/P content, occurs progressively in zones away from the direct implant surface.
    • The findings suggest that bone healing and maturation at the direct implant interface are not complete even after 90 days, highlighting the dynamic nature of osseointegration.