Strontium‐incorporated titanium implant surfaces treated by hydrothermal treatment enhance rapid osseointegration in diabetes: A preclinical vivo experimental study

Abstract Objectives The aim of the current study was to explore effects of strontium‐incorporated titanium implant surfaces by hydrothermal treatment on osseointegration in diabetic rats. Materials and Methods The surface characteristics of SLA and SLA‐Sr surfaces were detected by related instruments. Thirty‐six male Sprague‐Dawley rats were induced into diabetes, and thirty‐six rats were normal. SLA and SLA‐Sr implants were, respectively, inserted into bilateral tibial metaphysis of each rat. Percentage of bone‐to‐implant contact (BIC%) and percentage of bone area (BA%) were analyzed at 4 and 8 weeks after implantation. Immunohistochemistry of osteoprotegerin (OPG) and Wnt5a were conducted at 1 and 4 weeks. Gene expression levels of inflammatory cytokines and related signaling molecules in peri‐implant bone tissue were detected at 3 and 7 days. Results Strontium was uniformly distributed on SLA‐Sr surfaces, and it was released in an effective concentration range. SLA‐Sr surfaces showed significantly higher BIC% in diabetic rats at 4 ( p < .05) and 8 weeks ( p < .05). Besides, it displayed higher BIC% at 4 weeks ( p < .05) in normal rats. Also, SLA‐Sr surfaces upregulated expression of OPG at 4 weeks ( p < .05) in diabetic rats. What's more, SLA‐Sr surfaces downregulated inflammation (TNF‐α, IL‐1β, and IL‐6; p < .01) in diabetic rats at 3 days. In addition, expression of Wnt5a and ROR2 was upregulated ( p < .05) at 7 days after implantation under diabetes. Conclusion It is suggested that strontium‐incorporated titanium implant surfaces by hydrothermal treatment could enhance implant osseointegration as compared with SLA implant surfaces in diabetic rats.