Improved osseointegration of dental titanium implants by TiO(2) nanotube arrays with recombinant human bone morphogenetic protein-2: a pilot in vivo study

TiO(2) nanotube arrays on the surface of dental implants were fabricated by two-step anodic oxidation. Their effects on bone-implant contact were researched by a pilot in vivo study. The implants were classified into four groups. An implant group with TiO(2) nanotube arrays and recombinant human bone morphogenetic protein-2 (rhBMP-2) was compared with various surface implants, including machined surface, sandblasted large-grit and acid-etched surface, and TiO(2) nanotube array surface groups. The diameter of the TiO(2) nanotube window and TiO(2) nanotube were ~70 nm and ~110 nm, respectively. The rhBMP-2 was loaded into TiO(2) nanotube arrays and elution was detected by an interferometric biosensing method. A change in optical thickness of ~75 nm was measured by flow cell testing for 9 days, indicating elution of rhBMP-2 from the TiO(2) nanotube arrays. For the in vivo study, the four groups of implants were placed into the proximal tibia of New Zealand White rabbits. In the implant group with TiO(2) nanotube arrays and rhBMP-2, the bone-to-implant contact ratio was 29.5% and the bone volume ratio was 77.3%. Bone remodeling was observed not only in the periosteum but also in the interface between the bone and implant threads. These values were higher than in the machined surface, sandblasted large-grit and acid-etched surface, and TiO(2) nanotube array surface groups. Our results suggest that TiO(2) nanotube arrays could potentially be used as a reservoir for rhBMP-2 to reinforce osseointegration on the surface of dental implants.