Effects of Different Microstructured Surfaces on the Osseointegration of CAD/CAM Zirconia Dental Implants: An Experimental Study in Rabbits

Purpose: To assess different microstructured surfaces created by sandblasting and acid etching in an effort to optimize the osseointegration performance of dental zirconia implants with an optimized surface.
Materials and Methods: Sixty CAD/CAM zirconia implants were divided into four groups. The control group had no surface treatment after sintering. The other groups had three different types of surface modifications: sandblasting; sandblasting and etching with hydrofluoric acid; and sandblasting and etching with an experimental hot etching solution composed of methanol, 37% hydrochloric acid, and ferric chloride, heated to 100°C and applied for 60 minutes. Commercially available titanium implants with sandblasted and etched surfaces and identical dimensions were employed as a positive control. Surface micromorphologies of implants from the five groups were evaluated. The osseointegration performance of all the implants was assessed in adult New Zealand rabbits based on microcomputed tomography (micro-CT) and histologic analysis.
Results: Sandblasting and acid etching with hot etching solution or hydrofluoric acid exhibited moderately rough surfaces with microstructures in both microscale and nanoscale. The sandblasting and etching with hydrofluoric acid group showed the highest surface roughness. Micro-CT revealed a significantly lower mean bone volume/total volume for the control group compared with the other four groups (P < .05). Among the groups, the sandblasting and hydrofluoric acid etching group was the highest, significantly higher than the titanium implant and sandblasting groups (P < .05). The sandblasting and etching with hot etching solution (P = .006) group also showed a significantly higher bone volume/total volume value than the titanium implant group. Histologic analysis revealed significantly higher boneto- implant contact for implants with modified surfaces compared with a sintered surface (P < .05), and no significant difference was found with respect to the sandblasted and etched titanium implants.
Conclusion: The microstructured surfaces created by sandblasting and acid etching show osseointegration comparable to that of commonly used titanium implants.