Evaluations of bone tissue integration to pure and alloyed titanium implants

Purpose: This study was performed for comparisons of tissue integration to commercially pure (CP) and titanium-6-aluminum-4 vanadium (Ti-6-Al-4V) implants using various existing three-dimensional biomechanical and two-dimensional histomorphometrical techniques, and to monitor the loosening torque during in vivo removal torque (RTQ) test with a novel unit not used before in a pilot study in rabbits. Materials and Methods: The implants were topographically characterized and inserted in femurs and tibiae of five rabbits (in total 40 implants, 20 per group). After 16 weeks, the implant integration was biomechanically evaluated by: (1) resonance frequency test, and (2) peak RTQ test and the graph from the monitoring curve. Biopsies of the implants in situ were processed to undecalcified cut and ground sections followed by light microscopical quantifications. Shear strength calculations were performed. Results: Significantly higher mean value of RTQ (p = .01) and shear strength tests (p = .03) were observed for the CP titanium implants compared to Ti-6-Al-4V implants. The monitoring curve from the RTQ test demonstrated no differences in the shape or form that could provide further information about the differences in the implant-to-bone attachment. Conclusions: The CP titanium implants showed increased RTQ and shear strength values compared to the Ti-6-Al-4V implants. The new tool of monitoring the RTQ curve could not demonstrate differences between the two materials. The exact influence of the implant materials on the surrounding tissues needs to be further investigated.