title: Bone-titanium oxide interface in humans revealed by transmission electron microscopy and electron tomography.
abstract: Osseointegration, the direct contact between an implant surface and bone tissue, plays a critical role in interfacial stability and implant success. Analysis of interfacial zones at the micro- and nano-levels is essential to determine the extent of osseointegration. In this paper, a series of state-of-the-art microscopy techniques are used on laser-modified implants retrieved from humans. Partially laser-modified implants were retrieved after two and a half months' healing and processed for light and electron microscopy. Light microscopy showed osseointegration, with bone tissue growing both towards and away from the implant surface. Transmission electron microscopy revealed an intimate contact between mineralized bone and the laser-modified surface, including bone growth into the nano-structured oxide. This novel observation was verified by three-dimensional Z-contrast electron tomography, enabling visualization of an apatite layer, with different crystal direction compared with the apatite in the bone tissue, encompassing the nano-structured oxide. In conclusion, the present study demonstrates the nano-scale osseointegration and bonding between apatite and surface-textured titanium oxide. These observations provide novel data in human specimens on the ultrastructure of the titanium-bone interface.
authors.affiliation: Department of Biomaterials, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden. anders.palmquist@biomaterials.gu.se
authors.forename: Anders
authors.initials: A
authors.lastname: Palmquist
authors.forename: Kathryn
authors.initials: K
authors.lastname: Grandfield
authors.forename: Birgitta
authors.initials: B
authors.lastname: Norlindh
authors.forename: Torsten
authors.initials: T
authors.lastname: Mattsson
authors.forename: Rickard
authors.initials: R
authors.lastname: Brånemark
authors.forename: Peter
authors.initials: P
authors.lastname: Thomsen
mesh_terms: D000368:Aged; D001842:Bone and Bones / Q000648:ultrastructure*; D015921:Dental Implants; D055032:Electron Microscope Tomography; D006801:Humans; D007575:Jaw, Edentulous / Q000601:surgery; D008297:Male; D046529:Microscopy, Electron, Transmission; D016348:Osseointegration; D013499:Surface Properties; D013548:Sweden; D014025:Titanium
chemical_list: D015921:Dental Implants; C009495:titanium dioxide; D014025:Titanium