Callus formation and remodeling at titanium implants

Titanium is biocompatible with bone tissue, and during the healing process bone makes intimate contact with the implant surface. Although much is known about the long-term healing of implants, less is known about the callus formation at implants. In this study, the histology of bone healing was studied during the period between 4 and 14 days. Incisions were made in rat tibia. Some incisions were simply left to heal, while in others titanium discs were implanted. Smooth implants as well as implants with different porosities were used. After 4, 7, and 14 days of healing, the sites of bone incisions were retrieved, decalcified, sectioned, and stained. The aim was to compare normal fracture healing with implant healing and to see whether implant properties influenced the short-term healing process. Similarities between fracture healing and implant healing were evident. In both cases, inflammation, soft and hard callus formation, and remodeling had taken place during the period investigated. Between 7 and 14 days substantial bone resorption occurred around the implants. While after 14 days the marrow was almost completely reconstituted during normal wound healing, at the implants a thin layer of bone remained in close contact with the surface. Results from bone-implant contact measurements indicate that the surface properties of the implants do not have a significant influence on the early bone formation, since there were no significant differences between the smooth surface and any of the porous surfaces.