Osseointegration and foreign body reaction : Titanium implants activate the immune system and suppress bone resorption during the first 4 weeks after implantation

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Osseointegration and foreign body reaction : Titanium implants activate the immune system and suppress bone resorption during the first 4 weeks after implantation

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dc.contributor.author Prgomet, Zdenka sv
dc.contributor.author Tengvall, Pentti sv
dc.contributor.author Trindade, Ricardo en_US
dc.contributor.author Albrektsson, Tomas en_US
dc.contributor.author Galli, Silvia en_US
dc.contributor.author Wennerberg, Ann en_US
dc.date.accessioned 2018-07-13T07:05:26Z
dc.date.available 2018-07-13T07:05:26Z
dc.date.issued 2018 en_US
dc.identifier.issn 1523-0899 en_US
dc.identifier.uri http://hdl.handle.net/2043/25827
dc.description.abstract Background: Osseointegration mechanisms are still not entirely understood. PurposeThe present pilot study aims at demonstrating the involvement of the immune system in the process of osseointegration around titanium implants, comparing bone healing in the presence and absence of a titanium implant. Materials and Methods: Fifteen New Zealand White rabbits had one osteotomy performed at each of the distal femurs; on one side, no implant was placed (sham) and on the other side a titanium implant was introduced. Subjects were sacrificed at 10 and 28 days for gene expression analysis (three subjects each time point) and for decalcified qualitative histology (six subjects each time point). At 10 days, the three subjects for gene expression analysis were part of the six subjects for histology. Results: Gene expression analysis: at 10 days, ARG1 was significantly up-regulated around titanium, indicating an activation of M2-macrophages. At 28 days CD11b, ARG1, NCF-1, and C5aR1 were significantly up-regulated, indicating activation of the innate immune system, respectively M1-macrophages, M2-macrophages and group 2-innate lymphoid cells, neutrophils, and the complement system; on the other hand, the bone resorption markers RANKL, OPG, cathepsin K, and TRAP were significantly down-regulated around titanium. Histology: at 10 days new bone formation is seen around both sham and titanium sites, separating bone marrow from the osteotomy/implant site; at 28 days no bone trabeculae is seen on the sham site, which is healing at the original cortical level, whereas around titanium implants, bone continues into organization of more mature cortical-like bone, forming a layer between the implant and the bone marrow. Conclusions: The presence of a titanium implant during bone healing activates the immune system and displays type 2 inflammation, which is likely to guide the host-biomaterial relationship. At the same time, bone resorption is suppressed around titanium sites compared to sham sites after 4 weeks of implantation, suggesting a shift to a more pronounced bone forming environment. This suggests two important steps in osseointegration: identification of the titanium foreign body by the immune system and the development of a bone forming environment, that at tissue level translates into bone build-up on the titanium surface and can be perceived as an attempt to isolate the foreign body from the bone marrow space. en_US
dc.format.extent 10
dc.language.iso eng en_US
dc.publisher Wiley en_US
dc.subject animal study en_US
dc.subject bone en_US
dc.subject foreign body reaction en_US
dc.subject immunology en_US
dc.subject osseointegration en_US
dc.subject titanium en_US
dc.subject.classification Medicine en_US
dc.title Osseointegration and foreign body reaction : Titanium implants activate the immune system and suppress bone resorption during the first 4 weeks after implantation en_US
dc.type Article, peer reviewed scientific en_US
dc.contributor.department Malmö University. Faculty of Odontology
dc.identifier.doi 10.1111/cid.12578 en_US
dc.subject.srsc Research Subject Categories::ODONTOLOGY en_US
dc.relation.ispartofpublication Clinical Implant Dentistry and Related Research;1
dc.relation.ispartofpublicationvolume 20 en_US
dc.description.authorversion No en_US
dc.identifier.isiid 000424109400011
dc.identifier.pmid 29283206
dc.format.ePage 91
dc.format.sPage 82
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