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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Comparison of implant stability after different implant surface
treatments in dog bone</title><author><name sortKey="Kim, Sun Jong" sort="Kim, Sun Jong" uniqKey="Kim S" first="Sun-Jong" last="Kim">Sun-Jong Kim</name><affiliation><nlm:aff id="aff01"> DDS, MSD, PhD, Oral and Maxillofacial Surgery, School of Medicine, Ewha Womans University, Seoul, Korea.</nlm:aff></affiliation></author><author><name sortKey="Kim, Myung Rae" sort="Kim, Myung Rae" uniqKey="Kim M" first="Myung-Rae" last="Kim">Myung-Rae Kim</name><affiliation><nlm:aff id="aff02"> DDS, MSD, PhD, Oral and Maxillofacial Surgery, School of Medicine, Ewha Womans University, Seoul, Korea.</nlm:aff></affiliation></author><author><name sortKey="Rim, Jae Suk" sort="Rim, Jae Suk" uniqKey="Rim J" first="Jae-Suk" last="Rim">Jae-Suk Rim</name><affiliation><nlm:aff id="aff03"> DDS, MSD, PhD, Oral and Maxillofacial Surgery, College of Medicine, Korea University, Seoul, Korea.</nlm:aff></affiliation></author><author><name sortKey="Chung, Sung Min" sort="Chung, Sung Min" uniqKey="Chung S" first="Sung-Min" last="Chung">Sung-Min Chung</name><affiliation><nlm:aff id="aff04"> DDS, MSD, PhD, Well Dental Clinic, Seoul, Korea.</nlm:aff></affiliation></author><author><name sortKey="Shin, Sang Wan" sort="Shin, Sang Wan" uniqKey="Shin S" first="Sang-Wan" last="Shin">Sang-Wan Shin</name><affiliation><nlm:aff id="aff05"> DDS, MPH, PhD, Advanced Prosthodontics, Institute for Clinical Dental Research, Graduate School of Clinical Dentistry, Korea University , Seoul, Korea.</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">20835579</idno><idno type="pmc">5349075</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5349075</idno><idno type="RBID">PMC:5349075</idno><idno type="doi">10.1590/S1678-77572010000400016</idno><date when="2010">2010</date><idno type="wicri:Area/Pmc/Corpus">003016</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">003016</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Comparison of implant stability after different implant surface
treatments in dog bone</title><author><name sortKey="Kim, Sun Jong" sort="Kim, Sun Jong" uniqKey="Kim S" first="Sun-Jong" last="Kim">Sun-Jong Kim</name><affiliation><nlm:aff id="aff01"> DDS, MSD, PhD, Oral and Maxillofacial Surgery, School of Medicine, Ewha Womans University, Seoul, Korea.</nlm:aff></affiliation></author><author><name sortKey="Kim, Myung Rae" sort="Kim, Myung Rae" uniqKey="Kim M" first="Myung-Rae" last="Kim">Myung-Rae Kim</name><affiliation><nlm:aff id="aff02"> DDS, MSD, PhD, Oral and Maxillofacial Surgery, School of Medicine, Ewha Womans University, Seoul, Korea.</nlm:aff></affiliation></author><author><name sortKey="Rim, Jae Suk" sort="Rim, Jae Suk" uniqKey="Rim J" first="Jae-Suk" last="Rim">Jae-Suk Rim</name><affiliation><nlm:aff id="aff03"> DDS, MSD, PhD, Oral and Maxillofacial Surgery, College of Medicine, Korea University, Seoul, Korea.</nlm:aff></affiliation></author><author><name sortKey="Chung, Sung Min" sort="Chung, Sung Min" uniqKey="Chung S" first="Sung-Min" last="Chung">Sung-Min Chung</name><affiliation><nlm:aff id="aff04"> DDS, MSD, PhD, Well Dental Clinic, Seoul, Korea.</nlm:aff></affiliation></author><author><name sortKey="Shin, Sang Wan" sort="Shin, Sang Wan" uniqKey="Shin S" first="Sang-Wan" last="Shin">Sang-Wan Shin</name><affiliation><nlm:aff id="aff05"> DDS, MPH, PhD, Advanced Prosthodontics, Institute for Clinical Dental Research, Graduate School of Clinical Dentistry, Korea University , Seoul, Korea.</nlm:aff></affiliation></author></analytic><series><title level="j">Journal of Applied Oral Science</title><idno type="ISSN">1678-7757</idno><idno type="eISSN">1678-7765</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objectives</title><p>The purpose of this investigation was to evaluate the effects of different implant
surface treatments on implant stability in dog mandibles.</p></sec><sec><title>Material and Methods</title><p>A total of 30 implants (Dentium Co, Seoul, Korea) were placed in 5 dog mandibles.
Bone quality was assessed at each site. Implant stability was evaluated using 2
different methods. An Osstell™ resonance frequency analyzer (RFA) was used to
determine the stability at baseline (day 1), and 3, 6 and 10 weeks after surgery.
Animals were euthanized 10 weeks after implant installation. Specimens were
obtained and submitted to the laboratory processing. Sections were stained with
hematoxylin and eosin for histologic and histomorphometric analyses. All
implantation sites in dog mandibles demonstrated bone types II and III.</p></sec><sec><title>Results and Conclusions</title><p>All implants showed good primary stability at baseline in terms of insertion
torque. The results of this study suggest that surface treatment may have
significant effects on biological stability 3 weeks after implant placement.
Further studies are needed to confirm these initial observations in poor quality
bone.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Albrekttson, T" uniqKey="Albrekttson T">T Albrekttson</name></author><author><name sortKey="Br Nemark, Pi" uniqKey="Br Nemark P">PI Brånemark</name></author><author><name sortKey="Hansson, Ha" uniqKey="Hansson H">HA Hansson</name></author><author><name sortKey="Lindstrom, J" uniqKey="Lindstrom J">J Lindström</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cochran, Dl" uniqKey="Cochran D">DL Cochran</name></author><author><name sortKey="Buser, D" uniqKey="Buser D">D Buser</name></author><author><name sortKey="Ten Bruggenkate, Cm" uniqKey="Ten Bruggenkate C">CM ten Bruggenkate</name></author><author><name sortKey="Weingart, D" uniqKey="Weingart D">D Weingart</name></author><author><name sortKey="Taylor, Tm" uniqKey="Taylor T">TM Taylor</name></author><author><name sortKey="Bernard, Jp" uniqKey="Bernard J">JP 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uniqKey="Turkyilmaz I">I Turkyilmaz</name></author><author><name sortKey="Mcglumphy, Ea" uniqKey="Mcglumphy E">EA McGlumphy</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wennerberg, A" uniqKey="Wennerberg A">A Wennerberg</name></author><author><name sortKey="Albrektsson, T" uniqKey="Albrektsson T">T Albrektsson</name></author><author><name sortKey="Andersson, B" uniqKey="Andersson B">B Andersson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wennerberg, A" uniqKey="Wennerberg A">A Wennerberg</name></author><author><name sortKey="Albrektsson, T" uniqKey="Albrektsson T">T Albrektsson</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Appl Oral Sci</journal-id><journal-id journal-id-type="iso-abbrev">J Appl Oral Sci</journal-id><journal-title-group><journal-title>Journal of Applied Oral Science</journal-title></journal-title-group><issn pub-type="ppub">1678-7757</issn><issn pub-type="epub">1678-7765</issn><publisher><publisher-name>Faculdade de Odontologia de Bauru da Universidade de São
Paulo</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">20835579</article-id><article-id pub-id-type="pmc">5349075</article-id><article-id pub-id-type="doi">10.1590/S1678-77572010000400016</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Articles</subject></subj-group></article-categories><title-group><article-title>Comparison of implant stability after different implant surface
treatments in dog bone</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>KIM</surname><given-names>Sun-Jong</given-names></name><xref ref-type="aff" rid="aff01">1</xref><xref ref-type="corresp" rid="c01"></xref></contrib><contrib contrib-type="author"><name><surname>KIM</surname><given-names>Myung-Rae</given-names></name><xref ref-type="aff" rid="aff02">2</xref></contrib><contrib contrib-type="author"><name><surname>RIM</surname><given-names>Jae-Suk</given-names></name><xref ref-type="aff" rid="aff03">3</xref></contrib><contrib contrib-type="author"><name><surname>CHUNG</surname><given-names>Sung-Min</given-names></name><xref ref-type="aff" rid="aff04">4</xref></contrib><contrib contrib-type="author"><name><surname>SHIN</surname><given-names>Sang-Wan</given-names></name><xref ref-type="aff" rid="aff05">5</xref></contrib></contrib-group><aff id="aff01"><label>1</label> DDS, MSD, PhD, Oral and Maxillofacial Surgery, School of Medicine, Ewha Womans University, Seoul, Korea.</aff><aff id="aff02"><label>2</label> DDS, MSD, PhD, Oral and Maxillofacial Surgery, School of Medicine, Ewha Womans University, Seoul, Korea.</aff><aff id="aff03"><label>3</label> DDS, MSD, PhD, Oral and Maxillofacial Surgery, College of Medicine, Korea University, Seoul, Korea.</aff><aff id="aff04"><label>4</label> DDS, MSD, PhD, Well Dental Clinic, Seoul, Korea.</aff><aff id="aff05"><label>5</label> DDS, MPH, PhD, Advanced Prosthodontics, Institute for Clinical Dental Research, Graduate School of Clinical Dentistry, Korea University , Seoul, Korea.</aff><author-notes><corresp id="c01"><bold>Corresponding address:</bold> Sun-Jong Kim - 911-1 Mok-dong -
Yangcheon-gu - Seoul - Korea - Phone: 82-2-2650-5196 - Fax: 82-2-2650-5764 - e-mail:
<email>sjsj7777@ewha.ac.kr</email></corresp></author-notes><pub-date pub-type="epub-ppub"><season>Jul-Aug</season><year>2010</year></pub-date><pmc-comment>Fake ppub date generated by PMC from publisher
pub-date/@pub-type='epub-ppub' </pmc-comment>
<pub-date pub-type="ppub"><season>Jul-Aug</season><year>2010</year></pub-date><volume>18</volume><issue>4</issue><fpage>415</fpage><lpage>420</lpage><history><date date-type="received"><day>02</day><month>1</month><year>2009</year></date><date date-type="rev-recd"><day>21</day><month>9</month><year>2009</year></date><date date-type="accepted"><day>28</day><month>9</month><year>2009</year></date></history><permissions><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an Open Access article distributed under the terms of the Creative
Commons Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly
cited.</license-p></license></permissions><abstract><sec><title>Objectives</title><p>The purpose of this investigation was to evaluate the effects of different implant
surface treatments on implant stability in dog mandibles.</p></sec><sec><title>Material and Methods</title><p>A total of 30 implants (Dentium Co, Seoul, Korea) were placed in 5 dog mandibles.
Bone quality was assessed at each site. Implant stability was evaluated using 2
different methods. An Osstell™ resonance frequency analyzer (RFA) was used to
determine the stability at baseline (day 1), and 3, 6 and 10 weeks after surgery.
Animals were euthanized 10 weeks after implant installation. Specimens were
obtained and submitted to the laboratory processing. Sections were stained with
hematoxylin and eosin for histologic and histomorphometric analyses. All
implantation sites in dog mandibles demonstrated bone types II and III.</p></sec><sec><title>Results and Conclusions</title><p>All implants showed good primary stability at baseline in terms of insertion
torque. The results of this study suggest that surface treatment may have
significant effects on biological stability 3 weeks after implant placement.
Further studies are needed to confirm these initial observations in poor quality
bone.</p></sec></abstract><kwd-group><kwd>Implant surface</kwd><kwd>Primary stability</kwd><kwd>Bone quality</kwd><kwd>Histomorphometry</kwd><kwd>Resonance frequency analysis</kwd></kwd-group></article-meta></front><body><sec sec-type="intro"><title>INTRODUCTION</title><p>Implant stability is one of the crucial factors for a long-term success of
osseointegration. There are different methods of measuring implant stability, such as
percussion, radiograph, Periotest<sup>®</sup> (Siemens AG, Modautal, Germany),
Dental Fine Tester<sup>®</sup> (Kyocera, Kyoto, Japan), thread cutting force and
the reverse torque test. However, they have been criticized for lack of resolution, poor
sensitivity and susceptibility to being influenced by the operator. Resonance frequency
analysis (RFA) offers a clinical, non-invasive measure of stability and presumed
osseointegration of implants<sup><xref rid="r12" ref-type="bibr">12</xref>-<xref rid="r13" ref-type="bibr">13</xref>,<xref rid="r18" ref-type="bibr">18</xref></sup>.</p><p>Implant primary stability can be obtained by choosing an implant that matches bone
quality and by applying an appropriate surgical technique according to the bone
quality<sup><xref rid="r03" ref-type="bibr">3</xref></sup>. Sennerby, Thomsen and
ericson<sup><xref rid="r20" ref-type="bibr">20</xref></sup> (1992) analyzed the
healing process in the early stage of implantation by performing a research on reaction
of bone tissue in rabbit cortical and cancellous bone. In this study, those authors
emphasized the importance of cortical bone fixation. Although it is relatively easy to
obtain implant primary stability in cortical bone, it is somewhat difficult to achieve
implant primary stability in areas such as the maxillary molar area where severe bone
resorption, poor bone quality and lack of bone quantity are present. Some implant
researchers who have been interested in soft bone have attempted to overcome this
limitation by implant design and surface treatment. Glauser, et al.<sup><xref rid="r05" ref-type="bibr">5</xref></sup> (2001) have reported that implant design
and surface treatment have a significant influence on soft bone.</p><p>The aim of this study was to evaluate the effects of surface treatment on implant
primary stability using RFA and histomorphometric analysis.</p></sec><sec sec-type="materials|methods"><title>MATERIAL AND METHODS</title><p>Five male mongrel dogs weighing over 10 kg were used in this study. Animal selection/
management and surgery protocol followed the routines approved by the Animal Care and
Use Committee, Korea University, Seoul, Korea. Animals had access to a standard
laboratory diet and water until the beginning of the study. A total of 30 cylindrical
implants (Implantium<sup>®</sup>, Dentium Co., Seoul, Korea, 3.4 mm x 6 mm) were
used in this study (<xref ref-type="fig" rid="f01">Figure 1</xref>).</p><fig id="f01" orientation="portrait" position="float"><label>Figure 1</label><caption><p>Implants used in this study (3.4 mm in diameter, 6 mm in length)</p></caption><graphic xlink:href="jaos-18-04-0415-g01"></graphic></fig><p>Implants were divided into 3 groups: those which were machined and did not undergo any
surface treatment (group 1), those which were treated by SLA (group 2) and those which
were anodized by oxidized electricity using pulse power (Autoelectric Co., Seoul, Korea)
(group 3). The surface roughness of all groups was measured at the top of the thread
using a confocal laser scanning profilometer (TopScan3D<sup>®</sup>; UBM
Messtechnik GmbH, Germany) (<xref ref-type="table" rid="t01">Table 1</xref>).</p><table-wrap id="t01" orientation="portrait" position="float"><label>Tabela 1</label><caption><p>Implants used in this study (3 groups)</p></caption><table frame="hsides" rules="groups"><thead><tr style="background-color:#CCCCCC"><th align="center" rowspan="1" colspan="1"><bold>Group</bold></th><th align="center" rowspan="1" colspan="1"><bold>Surface</bold></th><th align="center" rowspan="1" colspan="1"><bold>Material and surface characteristics</bold></th><th align="center" rowspan="1" colspan="1"><bold>Roughness (Sa)</bold></th><th align="center" rowspan="1" colspan="1"><bold>Number</bold></th></tr></thead><tbody><tr><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr style="background-color:#CCCCCC"><td align="center" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">Machined</td><td align="center" rowspan="1" colspan="1">Smooth titanium,</td><td align="center" rowspan="1" colspan="1">0.86 |jm</td><td align="center" rowspan="1" colspan="1">10</td></tr><tr><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1">as-machined</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr style="background-color:#CCCCCC"><td align="center" rowspan="1" colspan="1">2</td><td align="center" rowspan="1" colspan="1">SLA</td><td align="center" rowspan="1" colspan="1">Sand blasted with large grit acid etched</td><td align="center" rowspan="1" colspan="1">1.76 jm</td><td align="center" rowspan="1" colspan="1">10</td></tr><tr><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr style="background-color:#CCCCCC"><td align="center" rowspan="1" colspan="1">3</td><td align="center" rowspan="1" colspan="1">Anodized</td><td align="center" rowspan="1" colspan="1">Anodic oxidation</td><td align="center" rowspan="1" colspan="1">1.02 jm</td><td align="center" rowspan="1" colspan="1">10</td></tr><tr><td align="center" rowspan="1" colspan="1">Total</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1">30</td></tr></tbody></table></table-wrap><p>Animals were preanesthetized by subcutaneous injection of buprenorphine HCl (Hanlim Co.,
Seoul, Korea, 0.02 mg/kg)/acepromazine (0.1 mg/kg)/ atropine (0.02 mg/kg). They were
then sedated with methohexital (5 mg/kg) and maintained on gas anesthesia (2%
isoflurane/O<sub>2</sub>). After scrubbing the surgical site with potadine, 1 mL of
2% lidocaine (Yu-Han Co., Seoul, Korea; 1:100,000) was injected into each surgical site
for local anesthesia. In order to create an edentulous alveolar ridge, 4 mandibular
premolar teeth were extracted from both sides of the lower jaw. After 3 months of
healing period, implants were installed under general anesthesia. This experiment was
undertaken as follows (<xref ref-type="fig" rid="f02">Figure 2</xref>). For each
implant, the insertion torque (IT), which represents the cutting resistance of bone when
its rotation is stopped, was registered in Ncm (INTRAsurg 300, KaVo, Bieberach,
Germany). The implants were placed at the bone level. After stable installation of
implants, cover screws were connected to them (<xref ref-type="fig" rid="f03">Figure
3</xref>)</p><fig id="f02" orientation="portrait" position="float"><label>Figure 2</label><caption><p>Experimental time points of this study</p></caption><graphic xlink:href="jaos-18-04-0415-g02"></graphic></fig><fig id="f03" orientation="portrait" position="float"><label>Figure 3</label><caption><p>Implant position in the dog’s lower jaw</p></caption><graphic xlink:href="jaos-18-04-0415-g03"></graphic></fig><p>All implantation sites tested in dog mandibles were demonstrated to be bone type II or
III. The surgical wound was sutured with 3-0 nonabsorbable sutures
(Mersilk<sup>®</sup>, ethicon Co., U.K.). In order to prevent infections,
kanamycin (50 mg/kg, Dong-A Co. Seoul, Korea) was injected intramuscularly for 7 days
after surgery. One week after the operation, the sutures were removed, and a soft diet
was provided for 2 weeks after surgery. A regular chow diet was supplied after 2 weeks.
Implant Stability Quotient (ISQ) was recorded using an Osstell mentor<sup>TM</sup>(Integration Diagnostics AB, Gothenburg, Sweden) at baseline (the day of surgery), and
3, 6 and 10 weeks after implant installation. All items measured in the experiment were
recorded with an Osstell mentor Data Manager (OmDM). The program also calculated the
mean and standard deviations. Generalized Linear Model in Statistical Package for the
Social Science (SPSS) for Windows (ver. 11.0, SPSS Inc.) was used for comparative
analysis among the groups.</p><p>Animals were sacrificed 10 weeks after implant installation, and histomorphometric
analysis was performed in order to measure the degree of osseointegration. Specimens
including implant (N=30) were prepared for histomorphometric analysis. The specimens
were stained with hematoxylin and eosin for light microscopy. Histomorphometric analysis
was performed by attaching a Kappa Dx30 digital camera (Optoelectronics, Gleichen,
Germany) on the light microscope (Olympus BX51, Olympus Co., Tokyo, Japan) and
transferring digital images to a computer monitor. Then, a quantitative analysis was
performed using Kappa image base metro (Kappa Opto-electronics, Germany) as an
image-analysis software: A. The bone-to-implant direct contact ratio (BIC) was measured
at the thread using a x40 magnification; B. The mineralized bone ratio was calculated by
measuring the total surface area of all threads (bone density: trabeculae, bone volume/
total volume).</p></sec><sec sec-type="results"><title>RESULTS</title><p>All implants showed a mean insertion torque value of 18.12±6.53 Ncm as compared
to a set torque of 40 Ncm and higher initial stability at baseline with an ISQ value
than recommended ISQ (Implant Stability Quetient) value 70. No statistically significant
differences were found among the 3 groups immediately after implantation (P>0.05).
The 3 groups showed similar ISQ changing patterns 0, 3, 6 and 10 weeks after implant
installation, with a decreasing pattern during the first 3 weeks and increasing 3 weeks
later (P<0.05) (<xref ref-type="table" rid="t02">Table 2</xref>) (<xref ref-type="fig" rid="f04">Figure 4</xref>). The bone-to-implant contact ratios of
groups 1, 2 and 3 in all threads were 60.8%, 69.6% and 73.6%, respectively. There was a
significant difference in the contact ratio between groups 1 and 3 (P<0.05). The
bone-to-implant contact ratio of groups 1, 2 and 3 in the 3 best continuous threads with
abundant bone quantity showed values of 68.6%, 81.2% and 83.2%, respectively. There was
a significant difference in the contact ratio between groups 1 and 2 and between groups
1 and 3 (P<0.05) (<xref ref-type="fig" rid="f05">Figure 5</xref>). For all threads,
bone density was 65.4% in group 1, 72.5% in group 2 and 71.1% in group 3. There was no
significant difference in bone density between the 3 groups (P>0.05). For the 3 best
continuous threads with abundant bone quantity, the bone density was 66.3% in group 1,
76.5% in group 2 and 75.7% in group 3 (<xref ref-type="fig" rid="f06">Figure
6</xref>).</p><table-wrap id="t02" orientation="portrait" position="float"><label>Tabela 2</label><caption><p>ISQ during healing period</p></caption><table frame="hsides" rules="groups"><thead><tr style="background-color:#CCCCCC"><th align="center" rowspan="1" colspan="1"><bold>Surface</bold></th><th align="center" rowspan="1" colspan="1"><bold>at installation</bold></th><th align="center" rowspan="1" colspan="1"><bold>3<sup>rd</sup>week</bold></th><th align="center" rowspan="1" colspan="1"><bold>6<sup>th</sup>week</bold></th><th align="center" rowspan="1" colspan="1"><bold>10<sup>th</sup>week</bold></th></tr></thead><tbody><tr><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr style="background-color:#CCCCCC"><td align="center" rowspan="1" colspan="1">Machined</td><td align="center" rowspan="1" colspan="1">71.33±2.42</td><td align="center" rowspan="1" colspan="1">69.33±3.14</td><td align="center" rowspan="1" colspan="1">70.67±2.58</td><td align="center" rowspan="1" colspan="1">70.83±3.31</td></tr><tr><td align="center" rowspan="1" colspan="1">SLA</td><td align="center" rowspan="1" colspan="1">71.67±3.33</td><td align="center" rowspan="1" colspan="1">71.36±3.72</td><td align="center" rowspan="1" colspan="1">72.33±1.63</td><td align="center" rowspan="1" colspan="1">72.83±1.94</td></tr><tr style="background-color:#CCCCCC"><td align="center" rowspan="1" colspan="1">Anodized</td><td align="center" rowspan="1" colspan="1">71.83±2.48</td><td align="center" rowspan="1" colspan="1">69.17±5.91</td><td align="center" rowspan="1" colspan="1">69.83±5.04</td><td align="center" rowspan="1" colspan="1">72.67±1.75</td></tr></tbody></table></table-wrap><fig id="f04" orientation="portrait" position="float"><label>Figure 4</label><caption><p>Changing pattern of implant stability quotient during the healing period following
implant installation in different types of implants (P<0.05)</p></caption><graphic xlink:href="jaos-18-04-0415-g04"></graphic></fig><fig id="f05" orientation="portrait" position="float"><label>Figure 5</label><caption><p>The bone-to-implant contact (BIC) ratio in different types of implant</p></caption><graphic xlink:href="jaos-18-04-0415-g05"></graphic></fig><fig id="f06" orientation="portrait" position="float"><label>Figure 6</label><caption><p>Bone density in different types of implants</p></caption><graphic xlink:href="jaos-18-04-0415-g06"></graphic></fig></sec><sec sec-type="discussion"><title>DISCUSSION</title><p>Dental implant surface has shown rapid evolution during the past few years<sup><xref rid="r06" ref-type="bibr">6</xref>,<xref rid="r17" ref-type="bibr">17</xref>,<xref rid="r23" ref-type="bibr">23</xref></sup>. This is because implant surface can
have a significant effect on long-term implant maintenance. Direct bone contact with
metallic substrate can be achieved in thin-film coated implants<sup><xref rid="r16" ref-type="bibr">16</xref></sup>.</p><p>It has been demonstrated that implant stability depends on the contact patterns between
bone and implant<sup><xref rid="r07" ref-type="bibr">7</xref></sup>. Stable initial
fixation may have an overt effect on long-term implant stability<sup><xref rid="r03" ref-type="bibr">3</xref></sup>. Several<sup><xref rid="r01" ref-type="bibr">1</xref>,<xref rid="r21" ref-type="bibr">21</xref>,<xref rid="r22" ref-type="bibr">22</xref></sup> reports indicate cortical bone, not bone in general to
be mainly responsible for implant stability.</p><p>Meredith, et al.<sup><xref rid="r12" ref-type="bibr">12</xref>,<xref rid="r13" ref-type="bibr">13</xref></sup> (1996, 1997) developed a reversible experimental method
to measure implant stability quantitatively. This reversible method allowed the
measurement of osseointegration depth according to elapsed time<sup><xref rid="r15" ref-type="bibr">15</xref></sup>. Friberg, et al.<sup><xref rid="r03" ref-type="bibr">3</xref></sup> (1999) have indicated that in compact
bone, stability decreases as time passes despite excellent bone adhesion and increased
contact between the implant and bone, whereas in soft bone, stability increases as time
passes. Those authors have also proposed that the initial implant stability decreases as
a result of bone compression caused by mechanical bone relaxation, biological changes
during the primary bone recovery stage, and initiation of marginal bone resorption.
Concerning the changes in stability according to elapsed time, Glauser, Portmann and
Ruhstaller<sup><xref rid="r05" ref-type="bibr">5</xref></sup> (2001) installed 20
TiUnite and 27 machined implants in the molar area of 9 and 15 patients, respectively.
They performed RFA for 6 months after implantation, which showed a decreasing pattern
for the first 3 weeks and then an increasing pattern thereafter.</p><p>In this study, ISQ values at baseline, 3, 6 and 10 weeks after implant installation were
significantly different among 3 groups. There was a changing pattern of ISQ values that
slightly decreased from implantation to 3 weeks post-implantation and increased
thereafter in all groups.</p><p>SLA treatment, a combination of blasting and acid treatment, is performed by sand
blasting the implant with 25-50 μm Al<sub>2</sub>O<sub>3</sub> particles and then
etching with HCl/H<sub>2</sub>SO<sub>4</sub> mixed solution. Cochran et al.<sup><xref rid="r02" ref-type="bibr">2</xref></sup> observed an increase in alkaline
phosphatase activity, DNA absorption in 3H chimicin's and collagenase by biochemically
testing the condition of cultured cells in the SLA-treated titanium phase.</p><p>When the anodizing method is used, a thick porous oxide film is formed. This film can
increase frictional force between implant and bone, and bone quantity and bone quality
changes depending on the pore size<sup><xref rid="r10" ref-type="bibr">10</xref></sup>.
Also, an improved surface accelerates recovery in the early stage by protein absorption,
platelet accumulation and activity, fibrin maintenance, and augmentation of the
surrounding bone tissues<sup><xref rid="r09" ref-type="bibr">9</xref></sup>. When bone
quality is poor, the contact rate between bone and implant decreases up to below 25%,
hindering implant primary stability which is an important factor in successful
osseointegration. In this study, the 3 groups did not show any significant difference in
primary stability because the experimental dogs had type II and III bone quality
mandibles and because the implants were completely fixated in all groups. This is in
agreement with the findings of O'Sullivan, et al.<sup><xref rid="r14" ref-type="bibr">14</xref></sup> (2004), who reported that implant primary stability did not show
any significant difference between type II and IV bone. They also found a significant
difference in the mean maximum insertion torque between type II and IV bone and between
type III and IV bone, whereas no significant difference was noted between types II and
III bone. Several reports have demonstrated the relationship between surface treatment
and bone quality. The authors have suggested that factors related to bone density and
implant diameter/length may affect the level of implant primary stability. Furthermore,
greater stability was observed in male patients than in female patients. High implant
primary stability was achieved in all jaw regions, although the use of thinner drills
and/or tapered implants cannot fully compensate for the effect of soft bone<sup><xref rid="r16" ref-type="bibr">16</xref></sup>. In contrast, Ganeles, et al.<sup><xref rid="r04" ref-type="bibr">4</xref></sup> (2008) reported that even in poor bone
quality, SLActive surface were safe and predictable when used in immediate and early
loading procedures. The survival rate was comparable with that of conventional loading.
The mean bone-level change was not deemed to be clinically significant and corresponded
well with typical bone resorption observed in conventional implant loading. Lazzara, et
al.<sup><xref rid="r11" ref-type="bibr">11</xref></sup> (1999) reported that the
osseointegration rate of a dual-acid-etched implant was twice as high as that of a
machined implant (73% versus 34%). In this study, the rate was higher in implants with
anodized surfaces, followed by those with SLA surfaces and those with machined surfaces.
In other words, surfacetreated implants showed a higher osseointegration rate (69%-76%)
than machined implants (60%) (P<0.05). Johansson, et al.<sup><xref rid="r08" ref-type="bibr">8</xref></sup> (1998) installed pure titanium and
titanium-aluminum-vanadium in rabbit bone and measured bone density 1, 6 and 12 months
after implantation. Bone density did not show significant differences around different
implant surfaces. In the present study, bone density was higher in SLA-treated implants,
followed by anodized and machined implants, but the differences were not statistically
significant (P>0.05). In SLA-treated implants, there was a significant difference in
bone density between cancellous and compact bone. This result suggests that there is a
significant difference in the bone response according to bone quality in textured
surface. It is well known that implants with rough surfaces increase the contact surface
area between implant and bone and thus improve the success rate of implants. Implants
with rough surfaces show a high success rate and an excellent clinical outcome when used
in poor quality bone<sup><xref rid="r20" ref-type="bibr">20</xref></sup>. Wennerberg, et
al.<sup><xref rid="r24" ref-type="bibr">24</xref></sup> (1993) stated that the
bone-to-implant contact ratio was higher in titanium implants with surface roughness
(Sa) of about 1.4 μm than in smoother implants (Sa=0.7-1.2 μm) or rougher implants (2.2
μm). In the present study, the bone-to-implant contact ratio was higher in anodized
surfaces with a roughness of 1.02 μm (73.6%±14.4%) and SLA-treated surfaces with
a roughness of 1.76 μm (69.6%±12.5%) than in machined surfaces with a roughness
of 0.86 μm (60.82%±13.11%).</p><p>In the present study, a good condition was created for implant primary stability by
providing microthreads and connecting them to a compact bone area. Marginal bone
resorption depending on elapsed time was minimized. It is considered that there were no
significant differences among the 3 groups because of the good mechanical stability and
the microthread design, which reduced marginal bone resorption.</p></sec><sec sec-type="conclusions"><title>CONCLUSION</title><p>The surface treatment had insignificant effects and did not affect implant stability in
a compact bone (dog mandible). Further studies are needed to confirm the effects of
microthreads on implant stability in bone.</p></sec></body><back><ack><title>ACKNOWLEDGMENTS</title><p>The authors acknowledge Dentium (Seoul, Korea) for donating the
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