A Histomorphometric Study of Bone Reactions to Titanium Implants in Irradiated Bone and the Effect of Hyperbaric Oxygen Treatment

The present study was undertaken to histomorphometrically analyze early peri-implant bone tissue reactions that occur after radiotherapy and to determine whether hyperbaric oxygen therapy (HBO) affects bone tissue at the microscopic level by altering bone morphology. Twelve rabbits received a single dose (15 Gy) of cobalt60 radiation to one hind leg and the other hind leg served as a control. Titanium screws were placed into the femur and tibia directly after irradiation. Six animals received HBO during the first 4 postoperative weeks. After 8 weeks of follow-up, bone specimens containing the screws were prepared for histomorphometry. Bone-metal contact and the amount of bone in the thread areas and in the mirror areas were measured in a blinded manner. Periosteal bone formation and bone remodeling decreased after irradiation; also after HBO treatment. Hyperbaric oxygen therapy improved bone formation in nonirradiated bone and to some extent also in the irradiated bone. Bone maturation was improved in the HBO animals after irradiation. It was concluded that irradiation reduces the capacity for osseointegration of titanium implants. Hyperbaric oxygen treatment may improve bone formation and especially has positive effects on bone maturation after irradiation. Keywords: acute tissue reactions, histomorphometry, hyperbaric oxygen treatment, irradiation, osseointegrated implants