Hot isostatic pressing-processed hydroxyapatite-coated titanium implants: light microscopic and scanning electron microscopy investigations.

Hot isostatic pressing (HIP) was used in a new procedure to produce hydroxyapatite (HA) coatings on a commercially pure titanium (cpTi) substrate for osseous implantation. Eighteen HIP-processed HA-coated implants were placed in the inferior border of the mandibles in 2 Labrador retriever dogs and left submerged for 3 months. As control specimens, 12 sandblasted cpTi implants were placed in the same mandibles and, to compare the bone reaction, 2 additional plasma-sprayed HA-coated implants (Integral) were placed. Tissue reactions at the bony interfaces of the implants were studied in ground sections with the implants in situ, using ordinary, fluorescent, and polarized light microscopy and scanning electron microscopy (SEM). The HIP-processed HA coatings displayed an increased density in light microscopy and SEM as compared to plasma-sprayed coatings. Direct bone-implant contact was found in all 3 types of surfaces. However, the production of new bone was far more abundant for the HA-coated implants than for sandblasted cpTi implants. The presence of bone-forming and bone-resorbing cells indicated active bone remodeling in the interface area at 3 months after implant placement. The present results support the view that epitaxial bone growth may occur from the HA-coated implant surface. It was concluded that the increased density of the present HIP-processed HA material does not reduce the bioactive properties of the coatings.