Role of the blood clot stabilization in early bone regeneration and osseointegration

Abstract

Background: Blood clot formation is one of the first events in bone regeneration and osseointegration. The blood clot adheres to dental implants with hydrophilic surfaces more favorably than to those with hydrophobic surfaces. This appears to result in better bone healing and bone fill of defects around dental implants.

Objective: To assess the impact of blood clot stabilization at modSLA titanium implants on bone formation in chronic-type defects in a dog model.

Material & methods: Ten modSLA implants were installed in 5 dogs after creation of saddle-type buccal-lingual bony defects. In 5 implants (test sites), the blood clot was removed by sterile saline irrigation, while the clot was left undisturbed on the other 5 implants (control sites). After 8 weeks of healing, the animals were sacrificed and sections were prepared for histomorphometric analysis. The following measurements were performed: The residual defect length (DL), the buccal and lingual most coronal level of bone in contact with the implant (CBI-b and CPI-l), the new bone height (NBH), the percentage of bone to implant contact (BIC), the area of new bone fill (BF), the difference in buccal and lingual dimensions of CBI (D-CBI), and percentage of linear bone fill (PLF).

Results: the mean values of DL were similar in both groups (3.4 mm). All parameters assessed were consistently more favorable in control sites: CBI-b: 1.3 vs. 1.5, CBI-l: 1.3 vs. 0.8, D-CBI: -0.2 vs -0.5, NBH: 1.9 mm vs. 2.1 mm, PLF: 57.1% vs. 64.5% and BF: 4.4 mm? vs. 6.0 mm?. However, these differences were not statistically significant.

Conclusion: In the light of consistently more favorable parameters assessed for the healing of saddle-shaped bony defects around implants, it is assumed that a stabilized blood clot contributed to early bone regeneration and osseointegration. Undisturbed blood clot formation may, indeed, be a prerequisite for optimal treatment outcomes. However, owing to the small sample size in the present study, these tendencies ought to be explored in further studies.