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The Influence of Implant Design on the Kinetics of Osseointegration and Bone Anchorage Homeostasis

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Document pages: 33 pages

Abstract: Titanium implants have shown considerable success in terms of achieving quick and long-lasting stability in bone through the process of osseointegration. Further work aims to improve implant success rates by modifying implant surface design and geometry on the nano-, micro-, and macro- scales with the goal of achieving higher levels of bone anchorage more quickly. However, the most frequently used methods of analysis do not investigate bone anchorage as a whole but as a series of discrete points, potentially missing out on relevant insight which could inform the effects of topography on these 3 scale ranges. Herein we utilize an asymptotic curve fitting method to obtain a more biologically relevant description of reverse torque data and compare the anchorage of 12 different implant groups. Implant surface topography had a significant effect on the rate and degree of anchorage achieved during the initial bone formation period of osseointegration but was not found to influence the relative change in anchorage during bony remodeling. Threaded implants significantly decreased the time required to reach peak anchorage compared to non-threaded implants and implants with micro-topographically complex surfaces required a greater torque to be removed than implants without micron scale features. Nanotopography increased overall anchorage and decreased the time required to reach peak anchorage but to a lesser degree than microtopographically complex surfaces or threaded implants respectively. The curve fitting method utilized in the present study allows for a more integrated analysis of bone anchorage over time and allows for investigation of specific stages of osseointegration which may lead to a more targeted approach to implant design.

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