Accelerated and enhanced osteointegration of MAO-treated implants: histological and histomorphometric evaluation in a rabbit model

Abstract

A pretreatment procedure that creates a porous, mineral-coated surface on dental implants leads to superior integration into bone. Micro-arc oxidation (MAO) can be used to apply thick coatings enriched in phosphorus and calcium onto titanium implants. Researchers led by Baodong Zhao of The Affiliated Hospital of Qingdao University in China have demonstrated that this complex three-dimensional surface offers a supportive environment for bone growth. Zhao and colleagues examined the integration of MAO-treated titanium implants into the femurs of live rabbits relative to implants with smooth surfaces. After 12 weeks, MAO promoted more active bone formation and mineral deposition, and the researchers observed that bone cells readily penetrated the porous surface of these implants to enable extensive skeletal integration. These results suggest that this procedure might meaningfully improve the outcome of dental procedures in the clinic.

References

[1] Elias CN, . Biomedical applications of titanium and its alloys. JOM, 2008, 60: 46-49.

[2] Huang, Q., et al. Specific heat treatment of selective laser melted Ti–6Al–4V for biomedical applications. Mater. Sci. 1–9 (2016).

[3] Buser D, . 10-year survival and success rates of 511 titanium implants with a sandblasted and acid-etched surface: a retrospective study in 303 partially edentulous patients. Clin. Implant. Dent. Relat. Res., 2012, 14: 839-851.

[4] Zhou X, . Promotion of bone formation by naringin in a titanium particle-induced diabetic murine calvarial osteolysis model. J. Orthop. Res., 2010, 28: 451-456.

[5] Buser D, . Influence of surface characteristics on bone integration of titanium implants. A histomorphometric study in miniature pigs. J. Biomed. Mater. Res., 1991, 25: 889-902.

[6] Gittens RA, . Implant osseointegration and the role of microroughness and nanostructures: Lessons for spine implants. Acta Biomater., 2014, 10: 3363-3371.

[7] Ehrenfest DMD, . Classification of osseointegrated implant surfaces: materials, chemistry and topography. Trends Biotechnol., 2010, 28: 198-206.

[8] Jiang XP, . Enhancement of fatigue and corrosion properties of pure Ti by sandblasting. Mat. Sci. Eng. A, 2006, 429: 30-35.

[9] Cho SA, Park KT. The removal torque of titanium screw inserted in rabbit tibia treated by dual acid etching. Biomaterials, 2003, 24: 3611.

[10] Gu YW, Khor KA, Cheang P. In vitro studies of plasma-sprayed hydroxyapatite/ Ti-6Al-4V composite coatings in simulated body fluid (SBF). Biomaterials, 2003, 24: 1603-1611.

[11] Kim HW, . Hydroxyapatite coating on titanium substrate with titania buffer layer processed by sol-gel method. Biomaterials, 2004, 25: 2533-2538.

[12] Samanipour F, . An innovative technique to simply fabricate ZrO₂-HA-TiO₂ nanostructured layers. Colloid Surf. B, 2011, 86: 14-20.

[13] Zeng R, . In vitro corrosion and cytocompatibility of a microarc oxidation coating and poly (L-lactic acid) composite coating on Mg-1Li-1Ca alloy for orthopaedic implants. ACS Appl. Mater. Inter, 2016, 8: 10014.

[14] Wang L, . Structure and composition of ceramic coating on the surface of titanium by microarc oxidation. Chin. J. Prosthodont., 2006, 7: 125-127.

[15] Zhang X, . Effect of electrolyte parameters on micro-arc oxidation of aluminum alloy. Mater. Prot., 2002, 35: 39-41.

[16] Cui LY, . Corrosion resistance of a self-healing micro-arc oxidation /polymethyltrimethoxysilane composite coating on magnesium alloy AZ31. Corros. Sci., 2017, 118: 84-95.

[17] Cui LY, . Degradation mechanism of micro-arc oxidation coatings on biodegradable Mg-Ca alloys-The influence of porosity. J. Alloy. Compd., 2017, 695: 2464-2476.

[18] Han Y, Hong SH, Xu K. Synthesis of nanocrystalline titania films by micro-arc oxidation. Mater. Lett., 2002, 56: 744-747.

[19] Ishizawa H, Ogino M. Formation and characterization of anodic titanium oxide films containing Ca and P. J. Biomed. Mater. Res., 1995, 29: 65-72.

[20] Wang HY, . Effect of sandblasting intensity on microstructures and properties of pure titanium micro-arc oxidation coatings in an optimized composite technique. Appl. Surf. Sci., 2014, 292: 204-212.

[21] Dunleavy CS, . Characterisation of discharge events during plasma electrolytic oxidation. Surf. Coat. Tech., 2009, 203: 3410-3419.

[22] Kim Y. Surface modification of Ti dental implants by grit-blasting and micro-arc oxidation. Mater. Manuf. Proces., 2010, 25: 307-310.

[23] Wang Q, . Enhanced performance of osteoblasts by silicon incorporated porous TiO₂ coating. J. Mater. Sci. Technol., 2012, 28: 109-117.

[24] Sul YT, . The bone response of oxidized bioactive and non-bioactive titanium implants. Biomaterials, 2005, 26: 6720-6730.

[25] Zeng, R. et al. In: Proceedings of the 8th International Conference on Magnesium Alloys and Their Applications, 961–966 (Wiley-VCH, Weinheim 2009).

[26] Gu XN, . Corrosion resistance and surface biocompatibility of a microarc oxidation coating on a Mg-Ca alloy. Acta Biomater., 2011, 7: 1880-1889.

[27] Teng FY, . The structures, electrochemical and cell performance of titania films formed on titanium by micro-arc oxidation. J. Taiwan Inst. Chem. E, 2014, 45: 1331-1337.

[28] Felgueiras HP, . Biotribocorrosion (tribo-electrochemical) characterization of anodized titanium biomaterial containing calcium and phosphorus before and after osteoblastic cell culture. J. Biomed. Mater. Res., 2014, 103: 661-669.

[29] Alves AC, . Tribocorrosion behaviour of anodic treated titanium surfaces intended for dental implants. J. Phys. D. Appl. Phys., 2013, 46: 404001.

[30] Oliveira FG, . Understanding growth mechanisms and tribocorrosion behaviour of porous TiO₂, anodic films containing calcium, phosphorous and magnesium. Appl. Surf. Sci., 2015, 341: 1-12.

[31] Treccani L, . Functionalized ceramics for biomedical, biotechnological and environmental applications. Acta Biomater., 2013, 9: 7115-7150.

[32] Alghamdi HS, . Osteogenicity of titanium implants coated with calcium phosphate or collagen type-I in osteoporotic rats. Biomaterials, 2013, 34: 3747-3757.

[33] Sul YT. The significance of the surface properties of oxidized titanium to the bone response: special emphasis on potential biochemical bonding of oxidized titanium implant. Biomaterials, 2003, 24: 3893-3907.

[34] Park JW, . Effects of phosphoric acid treatment of titanium surfaces on surface properties, osteoblast response and removal of torque forces. Acta Biomater., 2010, 6: 1661-1670.

[35] Ribeiro AR, . Micro-arc oxidation as a tool to develop multifunctional calcium-rich surfaces for dental implant applications. Mater. Sci. Eng. C., 2015, 54: 196-206.

[36] Cooper LF. Biologic determinants of bone formation for osseointegration: clues for future clinical improvements. J. Prosthet. Dent., 1998, 80: 439-449.

[37] Huang P, Zhang Y, Xu K, Han Y. Surface modification of titanium implant by microarc oxidation and hydrothermal treatment. J. Biomed. Mater. Res. B Appl. Biomater., 2004, 70: 187.

[38] Shen X, . Mesenchymal stem cell growth behavior on micro/nano hierarchical surfaces of titanium substrates. Colloid Surf. B, 2015, 127: 221.

[39] Guo Z, . Bone augmentation in a titanium cap with a porous surface modified by microarc oxidation. Int. J. Oral. Maxillofac. Implant., 2013, 28: 767-773.

[40] Orsini E, . Early healing events around titanium implant devices with different surface microtopography: a pilot study in an in vivo rabbit model. Sci. World J., 2012, 2012: 349842-349842.

[41] Kuzyk PR, Schemitsch EH. The basic science of peri-implant bone healing. Indian J. Orthop., 2011, 45: 108-115.

[42] Boonrungsiman S, . The role of intracellular calcium phosphate in osteoblast-mediated bone apatite formation. Proc. Natl. Acad. Sci. USA, 2012, 109: 14170-14175.

[43] Marco F, . Peri-implant osteogenesis in health and osteoporosis. Micron, 2005, 36: 630-644.

[44] Davies JE. Understanding peri-implant endosseous healing. J. Dent. Educ., 2003, 67: 932-949.

[45] Puleo DA, Nanci A. Understanding and controlling the bone-implant interface. Biomaterials, 1999, 20: 2311.

[46] Listgarten MA. Soft and hard tissue response to endosseous dental implants. Anat. Rec., 1996, 245: 410.

[47] Davies, J.E. & Hosseini, M.M. Histodynamics of endosseous wound healing. In Bone Engineering (eds Davies, J.E.) Em squared Inc., Toronto, Canada, 1–14 (2000).

[48] Chou HY, . Peri-implant bone remodeling around an extraction socket: predictions of bone maintenance by finite element method. Int. J. Oral. Maxillofac. Implant., 2012, 27: 39-48.

[49] Rashid H. Application of Confocal Laser Scanning Microscopy in Dentistry. J. Adv. Manag. Res., 2014, 9: 245-252.

[50] Glimcher MJ, Muir H. Recent Studies of the Mineral Phase in Bone and Its Possible Linkage to the Organic Matrix by Protein-Bound Phosphate Bonds [and Discussion]. Phlios. Trans. R. Soc. B, 1984, 304: 479.

[51] Anderson HC. Molecular biology of matrix vesicles. Clin. Orthop. Relat. Res., 1995, 314: 266-280.

[52] Mahamid J, . Amorphous calcium phosphate is a major component of the forming fin bones of zebrafish: indications for an amorphous precursor phase. Proc. Natl. Acad. Sci. USA, 2008, 105: 12748-12753.