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Implant surface topography affects connective tissue attachment to subcutaneous implants Kim, Hugh


A major concern with the implant-soft tissue interface is the aggressive proliferation of epithelium, which can be prevented in part by a firm attachment between the underlying connective tissue and the implant. Another problematic aspect is fibrous encapsulation of the implant, which denotes a failure of implant integration. The role of substrate texturing in maximizing fibroblast attachment and minimizing fibrous encapsulation has been documented previously. The aim of the present in vivo study is to evaluate the connective tissue attachment to titanium surfaces with varying degrees of roughness, including those found on commercially available dental implants. The roughness of the implant surfaces was previously quantified by numerical roughness (R[sub a]) values. Titanium-coated epoxy replicas were implanted subcutaneously in rats for periods ranging from 1-11 weeks. The implants were then processed for histomorphometric evaluation of connective tissue attachment, capsule thickness, and where applicable, the degree of separation between the tissue and implant. Statistical analysis revealed that the textured and rough substrata, namely the grooved (GR: V-shaped grooves, 30-um deep), titanium plasma-sprayed (TPS: R[sub a] =5.85 um), acid etched (AE: R[sub a] =0.59 um), coarsely blasted (CB: R[sub a] =5.09 um) and blasted and etched (SLA: R[sub a] =4.39 um) surfaces exhibited significantly (p<0.05) greater connective tissue attachment and thinner fibrous encapsulation when compared to the smooth, polished control surface (PO: R[sub a] =0.06 jam). In cases where separation occurred at the tissue-implant interface, this was of significantly (p<0.05) lower magnitude with the rough surfaces than the polished surface. The results indicate that rough implant surfaces are the most amenable to stable connective tissue attachment, which has implications for their use in percutaneous and permucosal applications, such as dental implant abutments.

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