Removal Torque and Histomorphometric Investigation of Surface Modified Commercial Implants: An Experimental Study in the Rabbit Tibia

상용화된 치과용 임플란트의 뒤틀림 제거력 및 조직학적 분석 연구: 가토 경골에서의 연구

  • Park, Jong-Hyun (Department of Prosthodontics and Research Institute of Oral Science, College of Dentistry, Kangnung National University) ;
  • Kim, Dae-Gon (Department of Prosthodontics and Research Institute of Oral Science, College of Dentistry, Kangnung National University) ;
  • Cho, Lee-Ra (Department of Prosthodontics and Research Institute of Oral Science, College of Dentistry, Kangnung National University) ;
  • Park, Chan-Jin (Department of Prosthodontics and Research Institute of Oral Science, College of Dentistry, Kangnung National University)
  • 박종현 (강릉대학교 치과대학 치과보철학교실 및 구강과학연구소) ;
  • 김대곤 (강릉대학교 치과대학 치과보철학교실 및 구강과학연구소) ;
  • 조리라 (강릉대학교 치과대학 치과보철학교실 및 구강과학연구소) ;
  • 박찬진 (강릉대학교 치과대학 치과보철학교실 및 구강과학연구소)
  • Received : 2007.12.23
  • Accepted : 2008.03.25
  • Published : 2008.03.30


The methods of surface modification of commercial implants were various according to the manufacturer. Surface modification of implant may produce diverse physical and chemical surface characteristics resulted from the treatment method and treatment condition. As a result, the bone response might be different. Even though surface modified implants have been used clinically, most researches are focusing on the bone response of surface modified implants comparing to machined implants rather than surface modified commercial implants. This study compare and analyze bone responses of 4 surface modified commercial implants with different shapes and surfaces. Eighty surface modified commercial implants with 4 different surface characteristics were installed in the tibia of white Newzealand rabbits. Biomechanical stability tests and histomorphometric evaluation were done. The results were as follows: 1. Surface modified commercial implants showed stable osseointegration at 6 weeks after installation. 2. Histomorphometric evaluation showed that there was no significant differences in bone to implant contact among 4 different commercial titanium implants. In comparing the implants with different shape the measurement of bone growth in subcortical area would be more reliable than entire bone to implant contact length. 3. Resonance Frequency Analysis showed that there was no significant differences among 4 types of implants, even though they were significantly different in installation. 4. There was significant differences in interfacial shear strength among 4 type of implants. 5. It is difficult to observe accurate bone to implant interface using Micro-CT. However, it is possible to measure the entire contact length of the implant to the bone.

상용 임플란트의 표면을 개질하기 위해 물리적, 화학적 방법을 이용한 새로운 표면이 증가하고 있으며 이에 대한 골반응도 다를 것으로 예상할 수 있지만 대부분의 연구는 단순히 기계절삭형 임플란트와의 비교만을 하고 있다. 본 연구에서는 4종의 다른 개질된 표면을 가진 상용 임플란트를 가토의 경골에 식립한 후 생역학적, 조직형태학적으로 비교하였다. 연구 결과, 모든 임플란트는 6주 후 안정적인 골유착을 이루고 있었으며 4종의 표면개질의 차이에 의한 공진주파수 및 조직형태학적 골반응의 차이는 없었으며 표면개질을 비교하기 위해 피질골 하방으로 증식한 골을 비교하는 것이 유용하였다. 생역학적, 조직형태학적 골반응에 비해 미세단층촬영(micro-CT)를 이용하는 비교법은 유용성과 정확도가 낮은 것으로 나타났다.


Supported by : 식품의약청안전청


  1. Branemark PI. Osseointegration and its experimental background. J Prosthet Dent. 1983;50:399-410
  2. Albreksson T, Zarb G, Worthington P, Eriksson AR. The long-term efficacy of currently and dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants. 1986;1:11-25
  3. Skalak R. Biomechanical considerations in osseointegred prostheses. J Prosthet Dent. 1983;49:843-848
  4. Han Y, Xu K. Photoexcited formation of bone apatite-like coatings on micro-arc oxidized titanium. J Biomed Mater Res. 2004;71:608-14
  5. Carlsson L, Rostlund T, Albrektsson B, Albrektsson T. Removal torque for polished and rough titanium implants. Int J Oral Maxillofac Implants. 1988;3:21-4
  6. Gotfredsen K, Nimb L, Hjrting-Hansen E, Jensen JS, Holmen A. Histomorphometric and removal torque analysis for Tio2-blasted titanium implants. An experimental study on dogs. Clin Oral Implants Res. 1992;3:77-84
  7. Cook SD, Baffes GC, Palafox AJ, Wolfe MW, Burgess A. Torsional stability of HA-coated and grit-blasted titanium dental implants. J Oral Implantol. 1992;18:354-8
  8. Ericsseon I, Johansson CB, Bystedt H, Norton MR. A histomorphometric evaluation of bone-to-implant contact on machine-prepared and roughened titanium dental implants. A pilot study in the dog. Clin Oral Implants Res. 1994;5:202-6
  9. Wennerberg A, Albrektsson T, Andersson B. Bone tissue response to commercially pure titanium implants blasted with fine and coarse particles of aluminum oxide. Int J Oral Maxilofac Implants. 1996;11:38-45
  10. Cook SD, Kay JF, Thomas KA, Jarcho M. Interface mechanics and history of titanium for dental implant applications. Int J Oral Maxillofc Implants. 1987;2:15-22
  11. Gottlander M, Albrektsson T. Histomorphometric analyses of hydroxyapatite-coated and uncoated titanium implants. The importance of the implant design. Clin Oral Implants Res. 1992;3:71-6
  12. Baker D, London RM, O'Neal R. Rate of pull-out strength gain of dual-etched titanium implants: A comparative study in rabbits.Int J Oral Maxillofac Implants. 1999;14:722-8
  13. Wong M, Eulenberger J, Schenk R, Hunziker E. Effect of surface topology on the osseointegration of implant materials in trabecular bone. J Biomed Mater Res. 1995;29:1567-75
  14. Taborelli M, Jobin M, Francois P, Vaudaux P, Tonetti M, Szmukler-Moncler S. Influence of surface treatments developed fororal implants on the physical and biological properties of titanium. (I) Surface characterization. Clin Oral Implants Res. 1997;8:208-16
  15. De Leonardis D, Garg AK, Pecora GE, Andreana S. Osseointegration of rough acid-etched implants: One-year follow-up of placement of 100 Minimatic implants. Int J Oral Maxillofac Implants. 1997;12:65-73
  16. Kurze P, Drysmann W, Knofler W. Anodic oxidation using spark discharge-a new surface treatment method for medical technology. Stomato DDR. 1986;36:549-54
  17. Larsson C, Thomsen P, Aronsson BO, Todahl M, Lausmaa J, Kasemo B, Ericson LE. Bone response to surface-modified titanium implants: studies on the early tissue response to machined and electropolished implants with different oxide thicknesses. Biomaterials. 1996;17:605-16
  18. Piattelli M, Scarano A, Paolantonio M, Iezzi G, Petrone G, Piattelli A. Bone response to machined and resorbable blast material titanium implants: an experimental study in rabbits. J Oral Implantol. 2002;27:2-8
  19. Kim JH, Han TS, Cho K, Kang SS, Kim G, Choi SH. Comparison of immediate and delayed implantation using the square-threaded and resorbable-blasted-media-treated surface implant system. In Vivo. 2007;21:55-9
  20. Perrin D, Szmukle-Moncler S, Echikou C, Pointaire P, Bernard JP.Bone response to alteration of surface topography and surface composition of sandblasted and acid etched (SLA) implants. Clin Oral Implants Res. 2002;13:465-9
  21. Khang W, Feldman S, Hawley CE, Gunsolley J. A multi-center study comparing dual acid-etched and machined-surfaced implants in various bone qualities. J Periodontol. 2001;72:1384-90
  22. Feldman S, Boitel N, Weng D, Kohles SS, Stach RM. Five-year survival distributions of short-length (10 mm or less) machined -surfaced and Osseotitie implants. Clin Implant Dent Relat Res. 2004;6:16-23
  23. Gotfredsen K, Karlsson U. A prospective 5-year study of fixed partial prostheses supported by implants with machined and TiO2-blasted surface. J Prosthodont. 2001;10:2-7
  24. Rocci A, Martignoni M, Gottlow J. Immediate loading of Branemark System Ti-Unite and machined-surface implants in the posterior mandible: a randomized open-ended clinical trial. Clin Implant Dent Relat Res. 2003;5:57-63
  25. Buser D, Nydegger T, Hirt HP, Cochran DL, Nolte LP. Removaltorque values of titanium implants in the maxilla of miniature pigs. Int J Oral Maxillofac Implants. 1998;13:611-9
  26. Gottlow J, Johansson C, Albrecktsson T, Lundgren AK. Biomechanical and histologic evaluation of Ti-Unite and Osseotite implant surfaces in rabbits after 6weeks of healing. Applied Osseointegration Res. 2001;1:25-7
  27. Gottlow J, Henry PJ, Tan AE, Allan BP, Hohansson C, Hall J. Biomechanical and histologic evaluation of Ti-Unite and Osseotite implant surfaces in dogs. Applied Osseointegration Res. 2001;1:28-30
  28. Sul YT, Johansson C, Albrektsson T. Which surface properties enhance bone response to implants? Comparison of oxidized magnesium, Ti-Unite, and Osseotite implant surfaces. Int J Prosthodont. 2006;19:319-28
  29. Sennerby L, Miyamoto I. Insertion torque and RFA analysis of Ti-Unite and SLA implants. A study in the rabbit. Applied Osseointegration Res. 2001;1:31-33
  30. Donath K, Breuner G. A method for the study of undecalcified bones and teeth with attaced soft tissues: The Sage z-Schliff (sawing and grinding) technique. J Oral Patho. 1982;11:318-26
  31. Johansson CB, Sennerby L, Albrektsson T. A removal torque and histomorphometric study of bone tissue reactions to commercially pure titanium and Vitallium implants. Int J Oral Maxillofac Implants. 1991;6:437-41
  32. Johansson CB, Albrektsson T. A removal torque and histomorphometric study of commercially pure niobium and titanium implants in rabbit bone. Clin Oral Implants Res. 1991;2:24-9
  33. Klokkevold PR, Nishimura RD, Adachi M, Caputo A. Osseointegration enhanced by chemical etching of the titanium surface. A torque removal study in the rabbit. Clin Oral Implants Res. 1997;8:442-7
  34. Buser D, Nydegger T, Hirt HP, Cochran DL, Nolte LP. Removal torque values of titanium implants in the maxilla of miniature pigs. Int J Oral Maxillofac Implants. 1998;13:611-9
  35. Buser D, Nydegger T, Oxland T, Cochran DL, Schenk RK, Hirt HP, Snetivy D, Nolte LP. Interface shear strength of titanium implants with a sandblasted and acid-etched surface: a biomechanical study in the maxilla of miniature pigs. J Biomed Mater Res. 1999;45:75-83<75::AID-JBM1>3.0.CO;2-P
  36. Inadome T, Hayashi K, Nakashima Y, Tsummura H, Sugioka Y. Comparison of bone-implant interface shear strength of hydroxy apatite-coated and alumina-coated metal implants. J Biomed Mater Res. 1995;29:19-24
  37. Ellingsen JE, Johansson CB, Wennerberg A, Holmen A. Improved retention and bone-to Implant contact with fluoride-modified titanium implants. Int J Oral Maxillofac Implants. 2004;19:659-66
  38. OsstellTM resonance frequencey analyser. Clinical Manual. Integration Diagnostics Ltd. Savedalen, Sweden. 2002
  39. Park CJ. Stability measurement on the implants of mandibular molar area using OsstellTM. J Korean Academy of Stomatognathic Function and Occlusion. 2004;17:205-11
  40. Friberg B, Senneby L, Linden B, Grondahl K, Lekholm U. Stability measurements of on-stage Branemark implants during healing in mandibles. A clinical resonance frequency analysis study. Int J Oral Maxillofac Surg. 1999;28:266-72
  41. Meredith N, Shagaldi F, Alleyne D, Sennerby L, Cawley P. The application of resonance frequency measurements to study the stability of titanium implants during healing in the rabbit tibia. Clin Oral Implants Res. 1997;8:234-43
  42. Sennerby L, Wennerberg A. & Pasop F. A new microtomographic technique for non-invasiveevaluation of the bone structure around implants. Clinical Oral Implants Res. 2001;12:91-4
  43. Park YS, Yi KY, Lee IS, Jung YC. Correlation between microtomography and histomorphometry for assessment of implant osseointegration. Clin Oral Implants Res. 2005;16:156-60
  44. Fanuscu MI, Chang TL. Three-dimensional morphometric analysis of human cadaver bone: microstructural data from maxilla and mandible. Clin Oral Implants Res. 2004;15:213-8
  45. Lugero GG, de Falco Caparbo V, Guzzo ML, Konig B, Jorgetti V. Histomorphometric evaluation of titanium implants in osteoporotic rabbits. Implant Dent. 2000;9:303-9
  46. Johansson C, Albrektsson T. Integration of screw implants in therabbit: a 1-year follow-up of removal torque of titanium implants. Int J Oral Maxillofac Implants. 1987;2:69-75