Impact of three-dimensional stabilization thread design on biomechanical fixation and osseointegration of endosteal implants

IF 3.3 2区医学 Q2 ENGINEERING, BIOMEDICAL

Journal of the Mechanical Behavior of Biomedical Materials Pub Date : 2025-04-08 DOI:10.1016/j.jmbbm.2025.107004

Blaire V. Slavin , Vasudev Vivekanand Nayak , Edmara T.P. Bergamo , Joseph P. Costello II , Quinn T. Ehlen , Zachary M. Stauber , Natalia Fullerton , Lukasz Witek , Paulo G. Coelho

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引用次数: 0

Abstract

Background

Implant's primary stability is determined by the intimate and immediate contact between the implant and osteotomy wall, whereas secondary stability is primarily influenced by healing chambers that facilitate the bone formation and remodeling processes following placement. Therefore, modifications to macro-geometric parameters are essential to elicit the desired in vivo response and to ensure successful osseointegration. Three-dimensional (3D) stabilization thread forms comprise both curved and linear geometric surfaces across the thread's crest maximizing retention forces while constraining lateral movement under load relative to conventional buttress-threaded implants.

Methods

This study utilized Ti-6Al-4V ELI implants with (i) a buttress thread design [Tapered Pro, BioHorizons®, Birmingham, AL, USA] (TP - control) compared to (ii) a novel, patented, 3D stabilization trimmed-thread design (TP 3DS - experimental). Implants were placed in the mandible of sheep (N = 14 sheep, 6 implants per group per sheep) and allowed to heal for 3- and 12-weeks (N = 7 sheep per time point). During implant placement (T = 0 weeks), the maximum insertion torque value (ITV) and implant stability quotient (ISQ) were measured by torque-in testing and resonance frequency analysis, respectively. After the healing periods, subjects were euthanized, and samples harvested en bloc for biomechanical evaluation via lateral loading tests in addition to histomorphometric and nanoindentation analysis.

Results

ITV values were significantly lower in the TP 3DS group compared to TP (p < 0.001). Both groups presented ISQ values ≥ 70, indicating high primary stability. Relative to the TP group, TP 3DS exhibited a significant (∼1.85-fold) increase in lateral load at 3 weeks (p = 0.029) and comparable load values at 12 weeks (p > 0.05). No quantitative differences in percentage of bone-to-implant contact (BIC) and bone-area-fraction-occupancy (BAFO) were observed at either time points between the two thread designs (p > 0.05). Similarly, no differences in bone's mechanical properties (Young's modulus (E) and Hardness (H)) between TP and TP 3DS were observed at 3- and 12- weeks (p > 0.05). Qualitatively, scattered microcracks were apparent at the outer threads of the implant, particularly within the TP group, whereas small bone chips were interspersed between threads of the 3DS implant serving as additional nucleation sites for bone formation.

Conclusion

The TP 3DS design reduced insertion torque, improved lateral loading competence, and resulted in a healing pattern, that are beneficial during early stages of osseointegration compared to TP implants.

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三维稳定螺纹设计对骨内种植体生物力学固定和骨整合的影响

植入物的主要稳定性取决于植入物与切骨壁之间的密切和直接接触，而次要稳定性主要受植入后促进骨形成和重塑过程的愈合室的影响。因此，修改宏观几何参数是必要的，以引起所需的体内反应，并确保成功的骨整合。三维（3D）稳定螺纹形式包括螺纹顶部的弯曲和线性几何表面，与传统的支撑螺纹植入物相比，最大限度地提高了固位力，同时限制了负载下的横向移动。方法本研究采用Ti-6Al-4V ELI植入物，采用(i)支撑螺纹设计[锥面Pro， BioHorizons®，Birmingham， AL, USA] （TP -对照）和（ii）新型专利3D稳定修剪螺纹设计（TP 3DS -实验）。将种植体放置于羊的下颌骨（N = 14只羊，每组每只羊6个种植体），让其愈合3周和12周（每个时间点N = 7只羊）。在种植体放置（T = 0周）期间，分别通过扭矩测试和共振频率分析测量最大插入扭矩值（ITV）和种植体稳定商（ISQ）。愈合期后，受试者被安乐死，并通过横向加载测试、组织形态测量和纳米压痕分析整体采集样本进行生物力学评估。结果TP 3DS组sitv值明显低于TP (p <；0.001)。两组的ISQ值均≥70，表明初级稳定性高。与TP组相比，TP 3DS在3周时表现出显著（约1.85倍）的侧负荷增加（p = 0.029），在12周时表现出相当的负荷值(p >；0.05)。在两种螺纹设计之间的任何时间点，没有观察到骨与种植体接触百分比（BIC）和骨面积百分比占用（BAFO）的定量差异(p >；0.05)。同样，在第3周和第12周，TP和TP 3DS之间的骨力学性能(杨氏模量（E)和硬度(H)）没有差异(p >；0.05)。定性上，在种植体的外螺纹处，特别是在TP组内，分散的微裂纹很明显，而在3DS种植体的螺纹之间散布着小骨屑，作为骨形成的额外成核位点。结论与TP种植体相比，TP 3DS设计减少了插入扭矩，提高了侧向载荷能力，并形成了愈合模式，有利于早期骨整合阶段。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the Mechanical Behavior of Biomedical Materials 工程技术-材料科学：生物材料

CiteScore

7.20

自引率

7.70%

发文量

505

审稿时长

46 days

期刊介绍： The Journal of the Mechanical Behavior of Biomedical Materials is concerned with the mechanical deformation, damage and failure under applied forces, of biological material (at the tissue, cellular and molecular levels) and of biomaterials, i.e. those materials which are designed to mimic or replace biological materials. The primary focus of the journal is the synthesis of materials science, biology, and medical and dental science. Reports of fundamental scientific investigations are welcome, as are articles concerned with the practical application of materials in medical devices. Both experimental and theoretical work is of interest; theoretical papers will normally include comparison of predictions with experimental data, though we recognize that this may not always be appropriate. The journal also publishes technical notes concerned with emerging experimental or theoretical techniques, letters to the editor and, by invitation, review articles and papers describing existing techniques for the benefit of an interdisciplinary readership.