Qualitative Analysis of Implant-Bone Interface After Implant Placement Implementing Condensation Technique In Vitro

The release of titanium nanoparticles during implant placement in dense bone is a significant concern, as it can potentially have adverse effects on the peri-implant tissues and an impact on the etiology of peri-implant diseases. The objective of this study was to examine the presence of titanium nanoparticles at the bone-implant interface during implant placement utilizing the bone condensation technique in vitro. Artificial Type IV bone slices (4mm thick) were securely held in place with a vice. Two groups of implants were placed. One group (test group) was placed under the condensation technique using cylindrical osteotomes. The other group (control group) was placed following the traditional surgical protocol. Implants were placed in parallel between bone slices held in a vice. Three groups of implant designs (6 implants in each group) were inserted into the bone. Two implant designs consisted of implants made of pure titanium (grade 4), while the third implant design group was constructed of titanium alloy (Ti6Al4V). Subsequently, the blocks were separated, and the peri-implant bone interface was qualitatively evaluated for titanium presence using X-ray-fluorescence spectrometry (XFS) at the coronal, middle, and apical thirds of osteotomies (n=12/ implant system). Descriptive statistical analysis showing the mean values (+/-SD) of titanium nanoparticles was performed. No detectable titanium levels were identified in the control group of titanium alloy-implants compared to pure titanium-implants. In contrast, the test group of all implant systems showed presence of titanium nanoparticles in coronal, middle, and apical thirds. Our results indicate that bone condensation technique is associated with titanium release during implant placement in vitro. These findings were shown for both pure titanium- and titanium alloy-dental implants.