Ultrastructural and electron diffraction of the bone-ceramic interfacial zone in coral and biphasic CaP implants

We investigated the influence of natural coral implants used as a bone substitute on the quality of bone ingrowth in rabbits 2, 3, and 6 weeks after implantation. Explants were characterized by transmission electron microscopy and electron diffraction. Bone ingrowth has been previously demonstrated by light microscopy, however, few have been performed in electron microscopy to compare mineralized tissue ingrowth in coral implants which occurs at the expense of calcium carbonate to that of calcium phosphate (CaP) implants. The interface between coral aragonite and mineralized tissue or bone was abrupt, with no invasion of the aragonite structure by newly formed crystals, as occurs in micropores when biphasic CaP (BCP) ceramics were used. The restoring process appears to be different from that induced by BCP implants. Precipitation of needle-like apatite crystals on the CaCO3 implant surface was not observed. Instead, apatitic smooth-shaped crystals formed in aggregates. The coral dissolution process does not release phosphate and so precipitation of apatite does not occur in the micropores of the coral implant, thereby limiting the formation of an apatite layer and hence bone bonding to the outer surface of the implant. In addition, on the outer surface of the implant, close to bone and a phosphorus source, the CaP crystals that do form are in aggregates presumably due to the carbonate and mismatch between the aragonite and the apatite. This seems to result in a delayed bone attachment or weaker bone bonding than CaP implants which encourage an epitaxial biological crystal deposition.