Influence of different drilling preparation on cortical bone: A biomechanical, histological, and micro-CT study on sheep

Clin Oral Implants Res. 2018 Jul;29(7):707-715. doi: 10.1111/clr.13262. Epub 2018 May 20.

Abstract

Objective: The aim of this study was to investigate the extent of cortical bone remodeling between two different drilling protocols by means of histomorphometric, µ-CT, and biomechanical analyses.

Material and methods: A total of 48 implants were inserted into the mandible of six sheep following two drilling protocols: Group A (Test, n = 24), undersized preparation; Group B (Control, n = 24), non-undersized preparation. The animals were euthanatized to obtain 5 and 10 weeks of implantation time. Removal torque (RTQ) was measured on 12 implants of each group and the peri-implant bone was µ-CT scanned. Bone volume density (BV/TV) was calculated in pre-determined cylindrical volumes, up to 1.5 mm from implant surface. Non-decalcified histology was prepared on the remaining 12 implants from each group, where total bone-to-implant contact (totBIC) and newly-formed BIC (newBIC) was measured. Bone Area Fraction Occupancy (BAFO) was determined in pre-determined areas up to 1.5 mm from implant surface. Paired sample t test or Wilcoxon signed-rank test was used to investigate differences between the groups.

Results: Group A presented significantly increased RTQ value at 5 weeks, while no difference was observed at 10 weeks. Group B presented increased BV/TV value at 5 weeks. Both groups showed comparable values for totBIC at both time-points. However, Group A presented significantly lower newBIC at 5 weeks. Higher BAFO was observed in Group B at 5 weeks.

Conclusions: Implants inserted into undersized sites has an increased biomechanical performance, but provoked major remodeling of the cortical bone during the early healing period compared to non-undersized preparations. After 10 weeks, no difference was observed.

Keywords: bone remodeling/regeneration; dental implant(s); osseointegration; osteotomy; torque; x-ray microtomography.

MeSH terms

  • Animals
  • Biomechanical Phenomena
  • Bone Remodeling
  • Cortical Bone / anatomy & histology
  • Cortical Bone / diagnostic imaging
  • Cortical Bone / surgery*
  • Dental Implantation, Endosseous / methods*
  • Female
  • Mandible / anatomy & histology
  • Mandible / diagnostic imaging
  • Mandible / surgery*
  • Osseointegration
  • Sheep
  • Torque
  • X-Ray Microtomography