Effects of implant design on marginal bone changes around early loaded, chemically modified, sandblasted acid-etched-surfaced implants: A histologic analysis in dogs

Abstract

Background: A minimal marginal bone loss around implants during early healing has been considered acceptable. However, the preservation of the marginal bone is related to soft tissue stability and esthetics. Implant designs and surfaces were evaluated to determine their impact on the behavior of the crestal bone. The purpose of this study is to evaluate histologic marginal bone level changes around early loaded, chemically modified, sandblasted acid-etched-surfaced implants with a machined collar (MC) or no MC (NMC). Methods: Three months after a tooth extraction, 72 sandblasted acidetched chemically modified implants were placed in six dogs. Thirty-six implants had NMC, and 36 implants had a 2.8-mm MC. All implants were loaded 21 days after placement. For histologic analyses, specimens were obtained at 3 and 12 months. Assessments of the percentage of the total bone-to-implant contact and linear measurements of the distance from the shoulder of the implant to the first bone-to-implant contact (fBIC) were performed. Based on fBIC measurements, estimates of bone loss were obtained for each implant. A mixed-model analysis of variance was used to assess the effects of implant type and sacrifice time. Results: All implants achieved osseointegration. The mean bone gain observed around NMC early loaded implants (at 3 months: 0.13 ± 0.37 mm; at 12 months: 0.13 ± 0.44 mm) was significantly different from the mean bone loss for MC early loaded implants (at 3 months: -0.32 ± 0.70 mm; at 12 months: -0.79 ± 0.35 mm) at 3 months (P = 0.003) and 12 months (P <0.001). No infrabony component was present at the marginal fBIC around NMC implants in most cases. There were no statistically significant differences among the means of total bone contact for implant types. Conclusions: Chemically modified, sandblasted acid-etched-surfaced implants with NMC presented crestal bone gain after 3 and 12 months under loading conditions in the canine mandible. The implant design and surface were determinants in the marginal bone level preservation.