Osseous adaptation to continuous loading of rigid endosseous implants.

Titanium implants, with an acid-etched surface, were screwed into holes 3 mm in diameter, about 1 cm apart, carefully prepared with an internally irrigated, surgical bur in the femurs of 3- to 6-month-old rabbits. During the first 3 days after surgery, fluorescent bone labels revealed extensive bone formation, particularly at the endosteal margin of the surgical defect, indicating preservation of a high degree of osteogenic capacity. A lattice of coarse, woven bone began encapsulating the implant within 3 days. By the end of 6 weeks, mature, lamellar bone filled voids at or near the implant surface and a rigid bone/implant interface was routinely achieved. Nonspecific, subperiosteal bony hypertrophy was noted within 6 weeks after implants were placed in young, growing animals (3 months old), but not in adults (6 months old). After 6 to 12 weeks of healing, a 100-gm load was applied for 4 to 8 weeks by stretching a stainless steel spring between the implants. All but one of twenty loaded implants remained rigid. Immediate loading of four pairs of implants resulted in spontaneous spiral-type ("torsional") fractures of the femur within 1 week. These results indicate that (1) relatively simple and inexpensive titanium implants develop a rigid osseous interface, (2) 6 weeks is an adequate healing period, prior to loading, to attain rigid stability and avoid spontaneous fracture, (3) continuously loaded implants remain stable within the bone, (4) bone formation is observed on periosteal surfaces subjected to concave flexure (compression), (5) cancellous-type bone orients perpendicularly between loaded implants, apparently corresponding to lines of stress, (6) new secondary osteons are propagated at or near the surface of loaded implants, (7) the remodeling (turnover) cycle for rabbit compact bone is about 6 weeks, and (8) endosseous implants have potential as a source of firm osseous anchorage for orthodontics and dentofacial orthopedics.