The effect of injectable calcium phosphate cement on bone anchorage of titanium implants: an experimental feasibility study in dogs

ICAP tube placed in an amalgamator for preparation. (a) Injection tip; (b) powder component; (c) liquid component.

Preparation of the implant beds in proximal tibia.

ICAP was injected into one of prepared implant beds.

Implants were inserted into ICAP injected site (arrow) and empty bed (asterisk).

Mean removal torque values (Ncm) after 2- and 12-week implantation periods.

Backscatter SEM images of 2-week healed implants. (a) Implant inserted with ICAP. ICAP has penetrated into a large area through the trabecular network (light grey area) and in direct contact with the native bone (dark grey area). Crack lines are present in the ICAP core in contact with the implant surface (arrows). Resorption of the ICAP is not complete. (b) Implant inserted with ICAP. Non-resorbed ICAP can be observed in the apex of the implant left from the drill space. ICAP is in direct contact with the implant surface and native bone. Fracture lines within the ICAP body reveal the mechanical breakdown of the cement before implant surface rupture (arrows). (c) Control implant. Implant body has detached from native bone with a thin gap along the bone–implant interface.

Backscatter SEM images of 12-week healed implants. (a) Implant inserted with ICAP. ICAP is still visible in the area but thinner compared with the level at 2 weeks. Crack lines are present in ICAP core and implant surface (arrows). (b) Implant inserted with ICAP. Cement is vastly resorbed with intact remnants still visible next to implant body (arrows). Implant body has detached from the bone surface area. (c) Control implant. Bone structure can be observed throughout the implant surface. Implant body has detached from the bone surface area.