Bone reactions to controlled loading of endosseous implants: a pilot study.

Objectives: To validate an experimental setup designed to apply load onto bone tissue using osseointegrated implants in a rabbit model. Specifically, (1) to design an apparatus capable of generating controlled forces, (2) to assess implant placement, maintenance and loading and (3) to evaluate outcome variables using three radiological methods.

Material And Methods: New Zealand White rabbits were used. Two dental implants were inserted 15-18 mm apart in the animals' tibiae. After 3 months of healing, the implants were loaded normal to their long axes using a pneumatically activated device. A 15 min load regimen at 1 Hz was applied 5 days per week. Every week the applied load was increased by 5 N up to week 8 and by 10 N up to 100 N by week 14. Groups of animals (n=3) were sacrificed at load levels 25, 50 and 100 N. One unloaded controlateral implant in each group provided the baseline data. The rabbits were computer tomography (CT) scanned and radiographed using conventional frames every 4-5 weeks. After sacrifice, a volume of interest (VOI) located in the inter-implant zones and a VOI set as a ring surrounding the distal implant were analyzed using micro computer tomography (microCT).

Results: A variety of osseous responses was observed, ranging from minor alterations to significant increases in porosity and lamelling of the cortical layer. microCT data of the inter-implant VOI demonstrated an initial increase in total volume (upto 50 N) followed by stabilization. Concomitantly, bone volumetric density first decreased and then augmented until the end of the experiment. This phenomenon was not observed in the peri-implant VOI, for which volumetric density augmented from the beginning to the end of the experiment.

Conclusions: 1. In future trials the loading devices must be constructed so as to sustain heavy cyclic loads over prolonged periods. 2. When properly handled, rabbits are cooperative animals in this application. In a third of the sites, signs of inflammation were observed. 3. In the inter-implant VOI, the cortical bone tended to react in two phases: first, as an increase in porosity and lamelling and second, as an augmentation of bone volumetric density. The peri-implant VOI adapted only by augmenting volumetric density.