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      Osseointegration of zirconia implants: an SEM observation of the bone-implant interface

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          Abstract

          Background

          The successful use of zirconia ceramics in orthopedic surgery led to a demand for dental zirconium-based implant systems. Because of its excellent biomechanical characteristics, biocompatibility, and bright tooth-like color, zirconia (zirconium dioxide, ZrO 2) has the potential to become a substitute for titanium as dental implant material. The present study aimed at investigating the osseointegration of zirconia implants with modified ablative surface at an ultrastructural level.

          Methods

          A total of 24 zirconia implants with modified ablative surfaces and 24 titanium implants all of similar shape and surface structure were inserted into the tibia of 12 Göttinger minipigs. Block biopsies were harvested 1 week, 4 weeks or 12 weeks (four animals each) after surgery. Scanning electron microscopy (SEM) analysis was performed at the bone implant interface.

          Results

          Remarkable bone attachment was already seen after 1 week which increased further to intimate bone contact after 4 weeks, observed on both zirconia and titanium implant surfaces. After 12 weeks, osseointegration without interposition of an interfacial layer was detected. At the ultrastructural level, there was no obvious difference between the osseointegration of zirconia implants with modified ablative surfaces and titanium implants with a similar surface topography.

          Conclusion

          The results of this study indicate similar osseointegration of zirconia and titanium implants at the ultrastructural level.

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          Most cited references19

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          Osseointegrated titanium implants. Requirements for ensuring a long-lasting, direct bone-to-implant anchorage in man.

          A total of 2895 threaded, cylindrical titanium implants have been inserted into the mandible or the maxilla and 124 similar implants have been installed in the tibial, temporal or iliac bones in man for various bone restorative procedures. The titanium screws were implanted without the use of cement, using a meticulous technique aiming at osseointegration--a direct contact between living bone and implant. Thirty-eight stable and integrated screws were removed for various reasons from 18 patients. The interface zone between bone and implant was investigated using X-rays, SEM, TEM and histology. The SEM study showed a very close spatial relationship between titanium and bone. The pattern of the anchorage of collagen filaments to titanium appeared to be similar to that of Sharpey's fibres to bone. No wear products were seen in the bone or soft tissues in spite of implant loading times up to 90 months. The soft tissues were also closely adhered to the titanium implant, thereby forming a biological seal, preventing microorganism infiltration along the implant. The implants in many cases had been allowed to permanently penetrate the gingiva and skin. This caused no adverse tissue effects. An intact bone-implant interface was analyzed by TEM, revealing a direct bone-to-implant interface contact also at the electron microscopic level, thereby suggesting the possibility of a direct chemical bonding between bone and titanium. It is concluded that the technique of osseointegration is a reliable type of cement-free bone anchorage for permanent prosthetic tissue substitutes. At present, this technique is being tried in clinical joint reconstruction. In order to achieve and to maintain such a direct contact between living bone and implant, threaded, unalloyed titanium screws of defined finish and geometry were inserted using a delicate surgical technique and were allowed to heal in situ, without loading, for a period of at least 3--4 months.
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            Intra-osseous anchorage of dental prostheses. I. Experimental studies.

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              Zirconia as a ceramic biomaterial.

              Zirconia ceramics have several advantages over other ceramic materials, due to the transformation toughening mechanisms operating in their microstructure that can give to components made out of them, very interesting mechanical properties. The research on the use of zirconia ceramics as biomaterials started about twenty years ago, and now zirconia (Y-YZP) is in clinical use in THR, but developments are in progress for application in other medical devices. Recent developments have concentrated on the chemistry of precursors, in forming and sintering processes, and on surface finish of components. Today's main applications of zirconia ceramics is in THR ball heads. This review takes into account the main results achieved up to now, and is focused on the role that microstructural characteristics play on the TZP ceramics behaviour in ball heads, namely mechanical properties and their stability, wear of the UHMWPE paired to TZP, and their influence on biocompatibility.
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                Author and article information

                Journal
                Head Face Med
                Head & Face Medicine
                BioMed Central
                1746-160X
                2008
                6 November 2008
                : 4
                : 25
                Affiliations
                [1 ]Department for Cranio- and Maxillofacial Surgery, Heinrich-Heine-University Duesseldorf, Germany
                [2 ]Department for Prosthetic Dentistry, Section of Materials Sciences, Johann Wolfgang Goethe University Frankfurt, Germany
                [3 ]Department for Operative and Preventive Dentistry and Endodontics, Heinrich-Heine-University Duesseldorf, Germany
                [4 ]Department for Cranio- and Maxillofacial Surgery, Westfalian Wilhelms-University Muenster, Germany
                Article
                1746-160X-4-25
                10.1186/1746-160X-4-25
                2583968
                18990214
                ad78acb9-1cab-4b84-bbe4-1e1dcddb81a0
                Copyright © 2008 Depprich et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 July 2008
                : 6 November 2008
                Categories
                Research

                Orthopedics
                Orthopedics

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