AnEx VivoModel in Human Femoral Heads for Histopathological Study and Resonance Frequency Analysis of Dental Implant Primary Stability

Abstract

Objective. This study was designed to explore relationships of resonance frequency analysis (RFA)—assessed implant stability (ISQ values) with bone morphometric parameters and bone quality in an ex vivo model of dental implants placed in human femoral heads and to evaluate the usefulness of this model for dental implant studies. Material and Methods. This ex vivo study included femoral heads from 17 patients undergoing surgery for femoral neck fracture due to osteoporosis (OP) (n = 7) or for total prosthesis joint replacement due to severe hip osteoarthrosis (OA) (n = 10). Sixty 4.5 × 13 mm Dentsply Astra implants were placed, followed by RFA. CD44 immunohistochemical analysis for osteocytes was also carried out. Results. As expected, the analysis yielded significant effects of femoral head type (OA versus OA) (P < 0.001), but not of the implants (P = 0.455) or of the interaction of the two factors (P = 0.848). Bonferroni post hoc comparisons showed a lower mean ISQ for implants in decalcified (50.33 ± 2.92) heads than in fresh (66.93 ± 1.10) or fixated (70.77 ± 1.32) heads (both P < 0.001). The ISQ score (fresh) was significantly higher for those in OA (73.52 ± 1.92) versus OP (67.13 ± 1.09) heads. However, mixed linear analysis showed no significant association between ISQ scores and morphologic or histomorphometric results (P > 0.5 in all cases), and no significant differences in ISQ values were found as a function of the length or area of the cortical layer (both P > 0.08). Conclusion. Although RFA-determined ISQ values are not correlated with morphometric parameters, they can discriminate bone quality (OP versus OA). This ex vivo model is useful for dental implant studies.

Evaluation of Alveolar Bone Quality: Correlation Between Histomorphometric Analysis and Lekholm and Zarb Classification

“…Regarding the osteocyte count, no statistical differences were observed between the different regions evaluated (P ¼ 02946). Herna ´ndez-Corte ´s et al (2014) 24 also used osteocyte count as an indicator to assess bone quality. However, the authors did not find statistically significant differences in the amount of osteocytes in the femoral head with osteoporosis and osteoarthritis.…”

“…Although it is not an applicable feature in the routine clinic, histometry is considered the gold standard to assess bone quality 24,25 . Trisi and Rao (1999) 10 found a positive correlation between the clinical and histomorphometric evaluation of bone quality after implant insertion in 56 patients, mainly in the differentiation of bone types I and IV.…”

Alveolar Bone Architecture: A Systematic Review and Meta‐Analysis

“…Bone grafting materials used for socket augmentation have influenced bone quality as well 9 . Changes in bone quality and quantity have a significant influence on performance of implant therapy 10 …”

Monitoring the Changes of Material Properties at Bone-Implant Interface during the Healing Process In Vivo: A Viscoelastic Investigation

“…Moreover, the study designs of the above-motioned studies differ in their selection of animal models, surgical techniques, and implant types. Similarly, Hernández-Cortés et al found no associations between initial ISQ values and histomorphometric results in human femoral heads [ 40 ]. This is because primary implant stability measured by ISQ values was significantly correlated with the cortical bone thickness, but not with bone histomorphometric parameters [ 23 , 37 , 41 ].…”