Osseointegration of anodized implant: effect of fibrin adhesive/TEA on primary stability

Abstract

Purpose: It is well known that the rate and strength of osseointegration is related to the direct connection between living bone and implant surface. Surface properties, such as topography, wettability, charge, surface energy, crystal structure, roughness, chemical potential, strain hardening, impurities, passive film thickness and coatings play important role for long-term clinical success. The association of fibrin adhesive material with tranexamic acid (TEA) is used to reduce fibrin degradation and prevent early blood clot breakdown. The aim of this study was to evaluate the bone healing around implants with anodized surface associated with fibrin adhesive/tranexamic acid and installed with compromised primary stability. Methods and materials: 80 implants of titanium ASTM F67 (Grade 4) with dimensions of 2.1 mm × 2.8 mm Ø were manufactured. They were divided (n = 10) into Group I (machined Ti), Group II (machined Ti/fibrin adhesive), Group III (machined Ti/tranexamic acid), Group IV (machined Ti/fibrin adhesive/tranexamic acid), Group V (anodized Ti), Group VI (anodized Ti/fibrin adhesive), Group VII (anodized Ti/tranexamic acid) and Group VIII (anodized Ti/fibrin adhesive/tranexamic acid). The anodized surface was formed using glycerol electrolyte (glycerol DI-H2O) with DC fields 50:50 (v/v) and NH4F solution (0.5–1.5%) by applying a pulsed DC field to the specimen (10–20 V) for a period of 3 h at 37 °C. The implants are surgically placed in tibia (defects with 2.5 mm × 3.2 mm Ø) of 80 male rats (250 g). The surgical sites were rinsed with 5% tranexamic acid solution in Groups III, IV, VII and VIII. In addition, were filled with fibrin adhesive into Groups II, IV, VI and VIII. The animals were euthanized at 60 days postoperative. The pieces were processed in methyl methacrylate (Stevenel's blue/Alizarin red). The samples were retrieved for bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) analyses. Results: BIC and BAFO analysis showed higher values for G8 compared with G1 (p < 0.05). There was no statistical difference among all other experimental groups for both BIC and BAFO analysis. Conclusion: The results of this study suggest that association fibrin adhesive material/tranexamic acid (TEA) had a positive effect on bone formation around implants with anodized surface and installed with compromised primary stability.