Evaluation of the surface integrity of hydroxyapatite-coated threaded dental implants after insertion

The surface characteristics and changes of hydroxyapatite-coated threaded dental implants after insertion into bone (veal calf ribs) with similar cortical and medullary characteristics to the human maxilla and posterior mandible (type III or IV bone) were studied. Hydroxyapatite-coated threaded implants from six vendors were coded A, B, C, D, E, and F. Four implants from each vendor were subjected to conventional placement following the manufacturer's instructions, placement without tapping of the osteotomy site, or evaluated as controls. The implants were recovered atraumatically and examined by scanning electron microscopy at x 35 and x 100 magnification. Photomicrographs were examined and graded by two independent examiners. Statistically significant differences were found using Kruskal-Wallis ANOVA and Wilcoxon Signed Ranks tests in surface integrity between conventional and nontapped treatment for groups C and D; between conventional placement and controls for groups A, B, and F; between nontapped placement and controls for groups A, B, C, D, and E; and among the manufacturers with respect to conventional placement for groups A, B, and E as compared with the other groups (P < 0.05). These findings suggest that surface changes of hydroxyapatite-coated threaded implants may occur during placement, particularly in undersized and untapped osteotomy sites. The changes could result in differences in integration and performance of some implant systems.