Comparative evaluation of the peri-implant bone tissue mineral density around unloaded titanium dental implants

Abstract 

Objective

The mechanical properties of bone are greatly influenced by the percentages of organic and mineral constituents. Nevertheless, the information about the mineral content on a microscopic scale in peri-implant bone is scarce. The aim of this work was to analyze the bone mineral density of peri-implant bone under different techniques.

Design

Five unloaded titanium dental implants with a micro-structured surface (three XiVE plus and two Frialit 2, DENTSPLY-Friadent, Mannheim, Germany) were retrieved from the mandible of five patients after a 6-month period. scanning electron microscopy with backscattered electron signal (BSE), light microscopy (LM) with a double staining technique, fluorescence microscopy and confocal laser microscopy were used for measuring microscopic mineral content variations in peri-implant bone. Histomorphometry and image intensity (grey level) were evaluated using a software package for image analysis.

Results

The low mineral density index (LMDI) for LM was of 29.2±3.1 (mean±S.D.), while the high mineral density index (HMDI) was of 88.2±3.6 (mean±S.D.). The one-way ANOVA analysis showed a significant difference (P<0.001) among the groups. The pairwise Holm–Sidak test identified the differences among HMDI indexes for both LM and SEM values and also for cross-evaluation of the LMDI and HMDI values. The comparison between LMDI indexes for both SEM and LM did not show any significance. The florescence microscopy analysis showed clearly the difference between old (high mineralized) and new (low mineralized) bone tissue near the implant surface. Under confocal laser microscopy the same sections showed the area of bone modelling closest to implant surface.

Conclusion

In this study it was found that bone around unloaded implants showed a low mineral density index under all the investigation methods used. It was also found that the conventional LM technique with the double staining method was able to intensely stain the bone area with a low mineral content.

Keywords: Backscattered electron imaging, Bone density, Light microscopy, Mineral content, Mineral density, Peri-implant bone, Dental implants, Osseointegration, Acid fuchsine, Oral implants, Bone