Early bone response to sandblasted, dual acid-etched and H2O2/HCl treated titanium implants: an experimental study in the rabbit

The aim of this study was to evaluate the influence of a roughened H2O2/HCl heat-treated titanium surface on peri-implant bone formation at an early stage in vivo. 24 Ti6Al4V alloy implants were used; half were treated by sandblasted and dual acid-etched treatments (control group), while the others were treated by sandblasted, dual acid-etched and H2O2/HCl heat treatments (test group). The morphology and roughness were analyzed by field emission SEM and atomic force microscopy. The implants were inserted into the femora of 12 adult white rabbits. After 2 and 4 weeks, femora block specimens were prepared for histological and histomorphometric analysis. SEM micrographs showed that multilevel and different sized pits were formed on both surfaces. New bone formation was observed on both implant surfaces. Test implants demonstrated a greater mean percentage of bone-implant contact as compared with controls at 2 (46.84 vs. 41.81, p=0.000) and 4 weeks (49.43 vs. 44.87, p=0.006) of healing. It is concluded that the H2O2/HCl heat-treated rough titanium surface promoted enhanced bone apposition during the early stages of new bone formation around the implant.