Enhanced Osseointegration of Titanium Alloy Bone Implants Coated With Carob-calcium Hydroxide Nanoparticles: A Comparative Study

Objectives: This study aimed to evaluate the osseointegration properties of titanium bone implants coated with carob-mediated calcium hydroxide nanoparticles biomechanically, radiographically, and histologically on rabbit tibias. Material and Methods: Forty coated and forty uncoated titanium alloy bone implants were inserted into 20 New Zealand rabbits; each tibia received 2 implants. The rabbits were sacrificed after 4 or 8 weeks, and samples were retrieved for biomechanical evaluation through removal torque test to assess the bond between implant and bone, radiographic evaluation through microcomputed tomography analysis to compare the bone-to-implant contact percentage and bone volume of the peri-implant area, scanning electron microscopic and histologic evaluation through hematoxylin and eosin stain. Statistical analyses between pairs of means were conducted using the independent t test. Multiple comparisons between the study groups across time intervals were performed using a 2-way analysis of variance. P -values ≤0.05 were considered statistically significant. Results: Higher removal torque values ( P <0.01) were needed to remove the coated implants when biomechanically tested. In addition, the microcomputed tomography evaluation revealed a higher bone-to-implant contact percentage ( P <0.05) in favor of coated implants. In addition, the 4-week healing interval of the coated implants showed no significant difference when compared with the 8-week healing interval of the uncoated implants biomechanically and radiographically, suggesting early osseointegration. Conclusions: The findings of this study imply that coating titanium implants with carob-mediated calcium hydroxide nanoparticles improved and fastened osseointegration and bone ingrowth, resulting in early osteogenesis and shortening the treatment time.