title: Comparative evaluation of the combined application of titanium implants and calcium phosphate bone substitutes in a rabbit model.
abstract: OBJECTIVE
  To study the healing of defects around titanium implants filled with biphasic calcium phosphates (BCP).
  
  
  METHODS
  Forty custom-made, titanium implants (Ti) with a diameter of 5 mm, and length of 8 mm, with two-sided gaps, were fabricated and installed in the femoral condyle of 20 rabbits. Following a randomization protocol, implants were alternately installed in one condyle without BCP bone substitute material (Ti) in the gaps and in the contralateral condyle gaps were filled with BCP bone substitute material (Ti+BCP). The implants were retrieved after 4 and 12 weeks of healing, after which histological and histomorphometrical analyses were done to assess the percentage of bone implant contact (BIC), the percentage of bone area (BA) and the percentage of particle area (PA) within the region of interest (ROI); the rectangular area joining the two arms of the L-shaped implant was considered as the ROI.
  
  
  RESULTS
  After 4 and 12 weeks of healing, Ti+BCP showed significantly higher BIC and BA values compared to Ti. Further, the BCP particles showed a significant decrease from 4 to 12 weeks of healing. The BCP particles (PA) showed a significant reduction from 31.6 ± 11.0% at 4 weeks to 21.0 ± 7.2% at 12 weeks.
  
  
  CONCLUSIONS
  The addition of BCP bone substitute to fill peri-implant gaps significantly enhanced both bone formation (~2.5-fold) and bone to implant contact (>2-fold) for the custom-made titanium implants with two-sided gaps.
authors: Department of Biomaterials (309), Radboudumc, Nijmegen, The Netherlands.|Department of Dentistry, Prince Sultan Military Medical City, Ministry of Defence, Riyadh, Saudi Arabia.
authors: Arwa
authors: A
authors: Alsayed
authors: Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
authors: Sukumaran
authors: S
authors: Anil
authors: Department of Biomaterials (309), Radboudumc, Nijmegen, The Netherlands.
authors: John A
authors: JA
authors: Jansen
authors: Department of Biomaterials (309), Radboudumc, Nijmegen, The Netherlands.
authors: Jeroen J J P
authors: JJ
authors: van den Beucken
mesh_terms: D000818:Animals; D001699:Biometry; D018786:Bone Substitutes / Q000008:administration & dosage*; D002130:Calcium Phosphates / Q000008:administration & dosage*; D003757:Dental Implantation / Q000379:methods*; D006651:Histocytochemistry; D008297:Male; D011817:Rabbits; D011897:Random Allocation; D014025:Titanium / Q000008:administration & dosage*; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D018786:Bone Substitutes; D002130:Calcium Phosphates; C020243:calcium phosphate; D014025:Titanium
keywords: biphasic calcium phosphate; bone grafting; bone substitute; histology; histomorphometry; intrabony defects