Revista Cienﬁca, FCV-LUZ / Vol. XXXV Recibido: 07/05/2025 Aceptado:21/07/2025 Publicado: 26/08/2025 hps://doi.org/10.52973/rcfcv-e35650 UNIVERSIDAD DEL ZULIA Serbiluz Sistema de Servicios Bibliotecarios y de Información Biblioteca Digital Repositorio Académico 1 of 6 Revista Cienﬁca, FCV-LUZ / Vol. XXXV hps://doi.org/10.52973/rcfcv-e35695 UNIVERSIDAD DEL ZULIA Serbiluz Sistema de Servicios Bibliotecarios y de Información Biblioteca Digital Repositorio Académico Evaluaon of Osseointegraon of Trabecular Titanium Implants Produced with Porous Metal Technology: An Experimental Study Evaluación De La Osteointegración De Implantes Trabeculares De Titanio Fabricados Con Tecnología De Metal Poroso: Un Estudio Experimental Erhan Cahit Ozcan 1 , Murat Tanrisever 2,* , Yildiz Aydin 3 , Bahar Tekin 3 , Asli Sagsoz 4 , Alihan Bozoglan 3 , Umit Koray Can 5 , Serkan Dundar 3,α ¹Firat University, Faculty of Medicine, Department of Esthec, Plasc and Recosntrucve Surgery, 23119, Elazig, Turkiye ²Firat Univeristy, Faculty of Veterinary Medicine, Department of Surgery, Elazig, 23119, Turkiye ³Firat University, Faculty of Denstry, Department of Periodontology, 23119, Elazig, Turkiye α Firat University, Instute of Sciences, Department of Stascs, 23119, Elazig, Turkiye ⁴Ministry of Health Bursa Dua Cinari Oral and Dental Health Center, 16110, Bursa, Turkiye ⁵Turkish Jockey Club Elazig Racecourse Horse Hospital, 23350, Elazig, Turkiye *Corresponding Author: mtanrisever@ﬁrat.edu.tr ABSTRACT Trabecular tanium (TM) implants produced with porous metal technology are used in dental implant treatments due to their resemblance to cancellous bone and their physical and mechanical properes. The objecve of this study was to perform a histological assessment and comparison of the bone–implant contact (BIC) rates between trabecular metal (TM) implants and convenonally machined-surface implants in rat femurThe study was conducted using twenty healthy adult male Sprague-Dawley rats, which were randomly allo- cated into two equal groups: one serving as the control group and the other receiving trabecular metal (TM) implants. All im- plants were surgically placed into the right femora of the rats. A curved incision approximately 10-15 mm long was made on the anterolateral aspect of the right knee. The knee joint cap- sule, formed by the femur and bia, was dissected. Following this procedure, the patella was subluxed, exposing the inter- condylar fossa of the femur for implant placement. Following a 4-week healing period, undecalciﬁed histomorphometric analyses of the samples were performed. BIC (%) measure- ments were conducted in the histomorphometric evaluaons. Group comparisons were analyzed using the Student’s t-test. TM implants exhibited an average BIC of 37.13%, while stan- dard cylindrical implants had an average BIC of 29.13%, with a signiﬁcant stascal diﬀerence between the two groups (P < 0.05). Within the limitaon of this study tanium implants produced with TM technology have higher percentages of BIC than standard cylindrical tanium implants. Key words: Titanium implants; trabecular tanium implant; porous metal; osseointegraon; bone implant connecon RESUMEN Los implantes de tanio trabecular (TM) producidos con tecnología de metal poroso se ulizan en tratamientos de implantes dentales debido a su semejanza con el hueso esponjoso y sus propiedades sicas y mecánicas. El objevo de este estudio fue comparar los niveles de conexión hueso- implante (BIC) de los implantes TM con los de los implantes de superﬁcie mecanizada producidos convencionalmente en fémur de rata mediante métodos histológicos. Se ulizaron veinte ratas Sprague-Dawley macho adultas sanas en el estudio. Las ratas se dividieron en 2 grupos iguales: controles e implantes TM. Los implantes se colocaron quirúrgicamente en los huesos del fémur derecho de todas las ratas. Se realizó una incisión curva de aproximadamente 10-15 mm de largo en el aspecto anterolateral de la rodilla derecha. Se diseccionó la cápsula de la arculación de la rodilla formada por el fémur y la bia. Después de este procedimiento, se subluxó la rótula y se expuso la fosa intercondilar del fémur para la colocación del implante. Después de un período de curación de 4 semanas, se realizaron análisis histomorfométricos no descalciﬁcados de las muestras. Se realizaron mediciones de BIC (%) en las evaluaciones histomorfométricas. Los datos se compararon ulizando la prueba t de Student. El porcentaje promedio de BIC (%) se registró en 37,13% en implantes TM y 29,13% en implantes cilíndricos estándar, y se detectó una diferencia estadíscamente signiﬁcava entre los grupos (P <0,05). Dentro de las limitaciones de este estudio, se encontró que los implantes de tanio producidos con tecnología TM tenían porcentajes de BIC más altos que los implantes de tanio cilíndricos estándar. Palabras clave: Implantes de tanio; implante trabecular de tanio; metal poroso; osteointegración; conexión hueso-implante

Revista Cienﬁca, FCV-LUZ / Vol. XXXV UNIVERSIDAD DEL ZULIA Serbiluz Sistema de Servicios Bibliotecarios y de Información Biblioteca Digital Repositorio Académico INTRODUCTION Titanium implants have important clinical advantages in, for example, aesthecs, comfort, and funcon and are extensively ulized in the ﬁeld of oral health care and craniofacial restoraon [1]. Since the 1970s, much work has been done on the development of tanium implants in denstry and craniofacial surgery. Today, tanium implants have become an indispensable part of oral and maxillofacial surgery and denstry clinics and are also widely used in treatment protocols [2]. The use of tanium dental implants has undergone a dynamic change in treang paents through modern treatment protocols, and long-term success rates have been reported during follow-ups [3 , 4 ,[5]. With the widespread use of tanium implants, many studies have been conducted on success criteria. The long- term maintenance of the bone–implant interface (BIC) is acknowledged as a crical determinant of implant success. Mulple variables inﬂuence the osseointegraon process between bone ssue and tanium dental implant surfaces, including bone density and volume, implant macrodesign and geometry, mechanical loading environment, and surface characteriscs. Opmal bone–implant interacon is strongly inﬂuenced by the surface topography, chemical composion, loading characteriscs, and hydrophilicity of the implant. These factors can inﬂuence protein adsorpon on the tanium implant surface, osteoblast acvity, and the formaon of new bone ssue [6 ,7,8]. Titanium implants have advantages, such as improved aesthecs and funcon, no damage to adjacent teeth, and signiﬁcant clinical eﬀects. They are also extensively ulized in dental clinical pracce for both fully and parally edentulous paents, as well as in maxillofacial prosthecs. However, certain limitaons in the applicaon areas can arise due to factors such as incomplete osseointegraon supply, peri-implant bone resorpon, and the occurrence of infecon symptoms between bone implants [5]. To overcome these limitaons and improve the long-term success of implants, considerable research has concentrated on the geometrical properes of dental implants, resulng in the development of diverse surface modiﬁcaons for tanium implants. Recently, dental implants have been developed with a range of surface composions and roughness levels. [6 ,7,8]. The topographical features of the implant surface play a crical role in osteoblast adhesion and diﬀerenaon during the early phase of osseointegraon, as well as in the regulaon of long- term bone remodeling. The primary goal of biomedical research on surface modiﬁcaons is to enhance inial osseointegraon and sustain long-term bone–implant contact (BIC) by prevenng peri-implant bone resorpon [9]. Numerous surface modiﬁcaon techniques have been developed for tanium implants to enhance the longevity and success of the implant– bone interface. Diﬀerent methods have been developed to increase the surface roughness or apply osteoconducve coangs to tanium implants [10]. In addion to recent advances in implant surface technology, trabecular metal (TM) producon technology has provided a new perspecve on implant producon. The TM architecture is similar to that of cancellous bone, and its physical and mechanical properes are similar to those of other prosthec materials. New bone can grow around the TM and ﬁll most of the exisng pore spaces. TM technology is a manufacturing technique developed for use in a variety of clinical applicaons in orthopedics, including spine devices, osteonecrosis treatment, and hip reconstrucon [11]. The purpose of the present study was to compare the BIC levels (%) of tanium implants produced with TM technology with those of machine-surfaced implants produced with tradional producon in rat femurs using nondecalciﬁed histological methods. MATERIAL AND METHODS Animals and study design All experimental procedures and animal care pracces were performed at the Firat University Experimental Research Center, Elazig, Turkiye. Ethical permission for the study was obtained from the Firat University Animal Experiments Ethics Committee (Protocol Number: 2017/48, Date: 21.04.2017). All rats (Raus norvegicus) used in the experiment were provided by the Firat University Experimental Research Center. All phases of the study were conducted in strict accordance with the World Medical Association’s Declaration of Helsinki, ensuring the ethical treatment and protection of laboratory animals used in experimental research. The study included twenty healthy adult male Sprague- Dawley rats, aged between 1 and 1.5 years. At the beginning of the experimental phase, the average body weight (WL, Shimadzu, Japan) of the rats was 500–550 g. The animals were housed in plasc cages in rooms with 24-hour temperature controls. The rats were allowed ad libitum access to food and water throughout the experiment. Animals were housed under a controlled 12-hour light/12-hour dark cycle. The rats were randomly selected and divided into the following 2 study groups, with 2 similar average weights: Titanium implants produced with TM technology: TM tanium implants (GÖR Group Medical Corporaon, Ankara, Türkiye) with a length of 6 mm and a diameter of 3 mm were placed in the corcocancellous bone of the right femur of the rats. Standard cylindrical implants (Controls): Standard cylindrical implants (GÖR Group Medical Corporaon, Ankara, Türkiye) of 3 mm in diameter and 6 mm in length were placed in the right femur corcocancellous bone of the rats. Surgical procedure Intramuscular administraon of Ketamine Hydrochloride (35 mg/kg) and Xylazine (5 mg/kg) was employed to induce general anesthesia. Surgical intervenons were conducted under strictly asepc condions to ensure sterility throughout the procedures. Before the surgery, following the inducon of general anesthesia, the operave area was shaved and disinfected with povidone–iodine. An incision approximately 10–15 mm in length was created along the anterolateral aspect of the right knee. The capsule encasing the bia and femur was carefully dissected, opened to facilitate access to the underlying structures. The patella was then parally shiﬅed to allow visualizaon of the femoral intercondylar notch. Subsequently, implant sockets were prepared using a drill (NSK, Japan) at 600 rpm, with intermient saline irrigaon to prevent 2 of 6

Evaluaon of Trabecular Titanium Implants / Ozcan et al. UNIVERSIDAD DEL ZULIA Serbiluz Sistema de Servicios Bibliotecarios y de Información Biblioteca Digital Repositorio Académico thermal injury. In order to inhibit carlage development on the implant surfaces, tanium implants were inserted through the arcular carlage and secured in the corcocancellous region of the femur, providing inial mechanical stability. A total of 20 implants, each 3 mm in diameter and 6 mm in length, were implanted into the femoral bone, with one implant inserted into each femur. Inseron torques were measured as 25 N/cm for standard cylindrical implants, while inseron torques were measured as 40 N/cm for trabecular implants. The implants were evenly distributed between the two experimental groups, with 10 allocated to each. To maintain procedural uniformity, all surgeries were conducted atraumacally by the same operator. Following implant placement, the knee joint capsule was reposioned, and subcutaneous ssue, skin and the fascia were closed using 4-0 polyglacn absorbable sutures. Upon compleon of the surgical procedures, all animals received intramuscular administraon of anbiocs (40 mg/kg Penicillin) and analgesics (1 mg/kg Tramadol hydrochloride) for a duraon of three d. Histomorphometrical analyses During the experimental period, no fatal or nonfatal complicaons were detected. The rats were euthanized 4 weeks aﬅer surgery. The implants were carefully dissected from the surrounding bone, muscle, and soﬅ ssues, and subsequently ﬁxed in 10 % formaldehyde soluon for preservaon. Following the ﬁxaon period, the specimens were embedded in 2-hydroxyethyl methacrylate resin to facilitate seconing of the undecalciﬁed bone and tanium. For histological and histomorphometric evaluaons, each sample was ground using a precision grinder to obtain a 50 µm-thick secon, which was then analyzed under a light microscope (Nikon, Japan). Toluidine blue staining was used for the histological analyses. The procedures were performed at the Research Laboratory of the Faculty of Denstry, Erciyes University, Kayseri, Turkey. Following the compleon of these procedures, histological and histomorphometric analyses were conducted to evaluate the bone ssue response around the implant siteHistopathological and histomorphometric analyses of BIC were conducted using an image analysis system (Nikon, Japan) at the Department of Medical Microbiology Laboratory, Faculty of Medicine, Firat University. In each secon, BIC was quanﬁed as the percentage of the total implant surface length that was in direct contact with bone ssue. [8]. Stascal analysis Stascal analysis were conducted using SPSS soﬅware version 23.0 for Windows (SPSS Inc.). Data normality was evaluated with the Shapiro–Wilk and Kolmogorov–Smirnov tests, which conﬁrmed that the data followed a normal distribuon. BIC values between groups were compared using the Student’s t-test. For all analyzed data, the mean ± standard deviaon was determined for each group, with P values < 0.05 considered stascally signiﬁcant. RESULTS AND DISCUSSION No cases of mortality, infecon, or wound dehiscence were observed during this protocol. The BIC parameters for both groups are shown in TABLE I. TABLE I Bone implant connecon rao (%) of the groups aﬅer the non decalciﬁed histopathological analysis Parameter Groups Mean Std. Dev P* Bone Implant Connecon Control (n=10) 29.13 6.53 0.027 Trabecular (n=10) 37.13 6.45 * Student T test (P<0.05 P=0.027). The average BIC values were found to be 37.13% in the TM implant group and 29.13% in the control group with standard cylindrical implants. Stascal analysis revealed a signiﬁcantly higher mean BIC percentage in the TM implant group compared to the standard implant group (FIGS. 1 A, B, C) and (FIGS. 2. A, B, C). FIGURE 1. Undecalciﬁed histological image of the convenonally produced implant. A: 2X, B: 4X, C: 10 X Magniﬁcaon (X: Ten mes magniﬁcaon). b: Bone, Yellow Line: Bone contact with the implant. Yellow arrow: Bone not contact the implant. BIC: Bone Implant Conneci- ton rao (%): Bone implant contact length/ Total implant surface length X 100 FIGURE 2. Undecalciﬁed histological image of the trabecular metal technology produced implant. A: 2X, B: 4X, C: 10 X Magniﬁcaon (X: Ten mes magniﬁcaon). b: Bone, Yellow Line: Bone contact with the implant. Geen Arrow: Bone ssue embedded in the implant trabecula. BIC: Bone Implant Conneciton rao (%): Bone implant contact length/ Total im- plant surface length X 100 3 of 6

Revista Cienﬁca, FCV-LUZ / Vol. XXXV UNIVERSIDAD DEL ZULIA Serbiluz Sistema de Servicios Bibliotecarios y de Información Biblioteca Digital Repositorio Académico Osseointegraon is deﬁned as the process involving inmate interacon between an implant and the surrounding bone ssue, leading to the mechanical ﬁxaon of the implant. [12]. The most current research on dental implants has focused on various surface treatments to develop a secure implant surface that promotes osseointegraon to increase surgical success rates in pracce [13]. Various implant surface modiﬁcaon techniques have been developed to enhance implant–bone integraon success. An ideal implant surface should promote peri-implant bone healing and facilitate the formaon of solid and well-organized mature bone, resulng in an osseointegrated implant that can resist the stresses of occlusal loading [14]. The speciﬁc eﬀects of tanium implant surface chemistry and topography on early osseointegraon processes have not yet been fully clariﬁed. Numerous methods have been developed and connue to be reﬁned to explore this relaonship [15]. The eﬀects of tanium implants produced using TM technology and tradional cylindrical tanium implants on osseointegraon were assessed histologically in this study. A signiﬁcantly higher average BIC value was obtained in TM implants than in standard cylindrical implants. Consistent with our ﬁndings, previous studies have indicated that porous surfaces serve as eﬀecve alternaves to rough implant coangs, enhancing the interface strength between bone and implant material [11 ,[16]. As a consequence, implant outcomes become more eﬀecve and stable. Addional beneﬁts of porous surfaces include reduced inial healing me, improved ﬁxaon, and enhanced cellular adhesion and vascularizaon. [11]. In contrast, solid (nonporous) implants permit bone growth only on their surfaces. Porous implants, however, are designed to achieve stabilizaon through bone ingrowth within their pores, thereby promong prolonged osseointegraon. This surface modiﬁcaon technique has been employed for over a decade to enhance the stability of orthopedic implants [16]. In addion to osteoconducon occurring in the pores around the implant, it has been suggested that preosteoblasts in blood clots within the TM implant biomaterial transform into osteoblasts by combining with calcium to form calciﬁed bone ssue in the pores and internal healing chambers of the TM implant. This process, involving both bone growth and ingrowth healing, is referred to as osseoincorporaon [11]. In a study histologically and clinically examining the eﬀects of TM implants on bone healing, the results supported the concept of osseoincorporaon. The results of the study showed that TM technology facilitates neovascularizaon of the material and supports bone growth and neoformaon within the implant. The highest value for BIC was seen in the TM group, which was signiﬁcantly higher than for the standard tanium implant [17]. In a clinical study by de Arriba et al. [18], they histomorphometrically evaluated progressive bone growth into TM implants in human jaws. The results showed that the combinaon of convenonal surface BIC (via geometric interference) supported by the formaon of an intramembranous-like bone in the interconnected TM network was directly compable with osseoincorporaon. This process resulted from the formaon of an osteogenic ssue network in the TM, resulng in vascular bone volume levels. Recently, porous-surface implants have been extensively studied in various animal models to assess their eﬀecveness in enhancing osseointegraon. Data synthesis and analysis from selected studies indicate that porous-surface implants may signiﬁcantly enhance the percentage of bone ﬁll during osseointegraon compared to their nonporous counterparts. A similar eﬀect may also occur for BIC [19]. In histomorphometric analysis, BIC is deﬁned as the percentage of the implant surface directly apposed to bone. However, for porous-surface implants, this measurement encompasses both the perimeter and the interior surfaces of the pores. [20]. In this study, as in similar studies, we used the BIC value (%), which is one of the most commonly used methods to evaluate the stability and osseointegraon levels of tanium implants [8 , 21 , 22 , 23]. A study by Lee et al. [24], evaluaon of the stability and histological evidence of osseoincorporaon in TM dental implants has demonstrated that porous implant surfaces posively inﬂuence bone formaon compared to nonporous surfaces. Another study concluded that the TM implant material enhances bone ingrowth, contribung to secondary implant stability, and proposed that it may also help resist peri- implant inﬂammaon [25]. In an 8-week in vivo study, the BIC percentages for implants placed in rabbit femoral condyles were 47.6 ± 8% for tanium implants and 57.9 ± 6.5% for TM implants with tapered screws. A stascally signiﬁcant higher BIC percentage was obtained for TM implants [20]. In another in vivo study at 4, 8, and 12 weeks, BIC percentage values of 42.8 ± 18.8 for TM implants and 13.7 ± 6.1 for standard cylindrical tanium implants were obtained at week 4, and BIC percentage values of 53.9 ± 13.2 for TM implants and 35.6 ± 9.6 for standard cylindrical tanium implants were obtained at week 12 [26]. The results of these studies show that BIC values in TM implants have improved signiﬁcantly. These data show the superiority of TM implants in terms of osseointegraon and implant stability. In parallel with the results of these studies, our study found that the stascally signiﬁcantly higher average BIC percentage obtained in TM implants reﬂects the posive eﬀect of these implants on bone–implant fusion. At the conclusion of the 4-week follow-up, the average BIC percentage was 37.13% for TM implants and 29.13% for standard cylindrical implants. These ﬁndings are consistent with those reported in previous studies [20 , 24 , 26]. Based on the results of this study, the signiﬁcantly higher percentage of bone–implant contact observed in TM implants compared to controls can be aributed to the enhanced surface roughness of the TM implants, which promotes superior bone– implant integraon [23 ,[27]. COCLUSION This study showed that there was a stascally signiﬁcant diﬀerence between the groups in the percentage of bone– implant fusion in the histological examinaon of TM and standard cylindrical implants. Within the limits of this study, higher success was observed in terms of osseointegraon on TM implant surfaces compared to standard cylindrical tanium implants. Implants produced with the TM method may have more successful clinical results. More studies are needed to fully understand the osseointegraon process in implants produced with TM technology. ACKNOWLEDGEMENT The authors wish to thanks GÖR Group Medical Corporaon, Ankara, Turkiye for manufacturing the implants 4 of 6

Evaluaon of Trabecular Titanium Implants / Ozcan et al. UNIVERSIDAD DEL ZULIA Serbiluz Sistema de Servicios Bibliotecarios y de Información Biblioteca Digital Repositorio Académico Funding There is no funding. Ethics approval and consent to parcipate Firat University Animal Experiment Local Ethic Comiee, Elazığ, Türkiye (approval number: 2017/48; date:21.04.2017). Conﬂicts of interest The authors declare no compeng of interest. BIBLIOGRAPHIC REFERENCES [1] Yang BC, Zhou XD, Yu HY, Wu Y, Bao CY, Man Y, Cheng L, Sun Y. Advances in tanium dental implant surface modiﬁcaon. West China Journal of Stomatology. [Internet]. 2019; 37(2):124-129. doi: hps://doi.org/ g65h4g [2] Alghamdi HS, Jansen JA. The development and future of dental implants. Dent. Mater. J. [Internet]. 2020; 39(2):167-172. doi: hps://doi.org/gqnkzm [3] Albrektsson T, Buser D, Sennerby L. Crestal bone loss and oral implants. Clin. Implant Dent. Relat. Res. [Internet]. 2012; 14(6):783-791. doi: hps://doi.org/f22q7f [4] Buser D, Sennerby L, De Bruyn H. Modern implant denstry based on osseointegraon: 50 years of progress, current trends and open quesons. Periodontol. 2000. [Internet]. 2017; 73(1):7-21. doi: hps://doi.org/f3t8sz [5] Annunziata M, Guida L. The Eﬀect of Titanium Surface Modiﬁcaons on Dental Implant Osseointegraon. Front. Oral Biol. [Internet]. 2015; 17:62-77. doi: hps://doi.org/ pzwk [6] Le Guehennec L, Goyenvalle E, Lopez-Heredia MA, Weiss P, Amouriq Y, Layrolle P. Histomorphometric analysis of the osseointegraon of four diﬀerent implant surfaces in the femoral epiphyses of rabbits. Clin. Oral Implants Res. [Internet]. 2008; 19(11):1103-1110. doi: hps://doi.org/ bxgbv2 [7] Le Guéhennec L, Soueidan A, Layrolle P, Amouriq Y. Surface treatments of tanium dental implants for rapid osseointegraon. Dent. Mater. [Internet]. 2007; 23(7):844-854. doi: hps://doi.org/b2rw2d [8] Dundar S, Yaman F, Gecor O, Cakmak O, Kirtay M, Yildirim TT, Karaman T, Benlidayi ME. Eﬀects of Local and Systemic Zoledronic Acid Applicaon on Titanium Implant Osseointegraon: An Experimental Study Conducted on Two Surface Types. J. Craniofac. Surg. [Internet]. 2017; 28(4):935-938. doi: hps://doi.org/gbh973 [9] Smeets R, Stadlinger B, Schwarz F, Beck-Broichsier B, Jung O, Precht C, Kloss F, Gröbe A, Heiland M, Ebker T. Impact of Dental Implant Surface Modiﬁcaons on Osseointegraon. Biomed. Res. Int. [Internet]. 2016; 2016:6285620. doi: hps://doi.org/f9jp5f [10] Stanford CM. Surface modiﬁcaons of dental implants. Aust Dent J. [Internet]. 2008; 53(Suppl1):S26-S33. doi: hps://doi.org/bgsg5v [11] Bencharit S, Byrd WC, Altarawneh S, Hosseini B, Leong A, Reside G, Morelli T, Oﬀenbacher S. Development and applicaons of porous tantalum trabecular metal- enhanced tanium dental implants. Clin. Implant Dent. Relat. Res. [Internet]. 2014; 16(6):817-826. doi: hps:// doi.org/gp3dgq [12] Velasco-Ortega E, Orz-Garcia I, Jiménez-Guerra A, Núñez-Márquez E, Moreno-Muñoz J, Rondón-Romero JL, Cabanillas-Balsera D, Gil J, Muñoz-Guzón F, Monsalve- Guil L. Osseointegraon of Sandblasted and Acid-Etched Implant Surfaces. A Histological and Histomorphometric Study in the Rabbit. Int. J. Mol. Sci. [Internet]. 2021; 22(16):8507. doi: hps://doi.org/gp5nmb [13] Yeo IL. Modiﬁcaons of Dental Implant Surfaces at the Micro- and Nano-Level for Enhanced Osseointegraon. Materials. [Internet]. 2020; 13(1):89. doi: hps://doi. org/gmwpwg [14] Bla S, Pabst AM, Schiegnitz E, Hosang M, Ziebart T, Walter C, Al-Nawas B, Klein MO. Early cell response of osteogenic cells on diﬀerently modiﬁed implant surfaces: Sequences of cell proliferaon, adherence and modiﬁed implant surfaces: Sequences of cell proliferaon, adherence and diﬀerenaon. J. Craniomaxillofac. Surg. [Internet]. 2018; 46(3):453-460. doi: hps://doi.org/ gc4zdt [15] Luke Yeo IS. Dental Implants: Enhancing Biological Response Through Surface Modiﬁcaons. Dent. Clin. North. Am. [Internet]. 2022; 66(4):627-642. doi: hps:// doi.org/gtq9h2 [16] Romanos GE, Delgado-Ruiz RA, Sacks D, Calvo-Guirado JL. Inﬂuence of the implant diameter and bone quality on the primary stability of porous tantalum trabecular metal dental implants: an in vitro biomechanical study. Clin. Oral Implants Res. [Internet]. 2018; 29(6):649-655. doi: hps://doi.org/pzwn [17] Bencharit S, Morelli T, Barros S, Seagroves JT, Kim S, Yu N, Byrd K, Brenes C, Oﬀenbacher S. Comparing Inial Wound Healing and Osteogenesis of Porous Tantalum Trabecular Metal and Titanium Alloy Materials. J. Oral. Implantol. [Internet]. 2019; 45(3):173-180. doi: hps:// doi.org/pzwp [18] de Arriba CC, Alobera Gracia MA, Coelho PG, Neiva R, Tarnow DP, Del Canto Pingarron M, Aguado-Henche S. Osseoincorporaon of Porous Tantalum Trabecular- Structured Metal: A Histologic and Histomorphometric Study in Humans. Int. J. Periodoncs Restorave Dent. [Internet]. 2018 [cited 05 Apr 2025]; 38(6):879–885. Available in: hps://goo.su/Ucon1 [19] Özcan EC, Aydin MA, Dundar S, Tanrisever M, Bal A, Karasu N, Kirtay M. Biomechanical Investigation of the Osseointegration of Titanium Implants With Different Surfaces Placed With Allogeneic Bone Transfer. J. Craniofac. Surg. [Internet]. 2024; 35(7):2184-2188. doi: hps://doi.org/pmwx [20] Al Deeb M, Aldosari AA, Anil S. Osseointegraon of Tantalum Trabecular Metal in Titanium Dental Implants: Histological and Micro-CT Study. J. Funct. Biomater. [Internet]. 2023; 14(7):355. doi: hps://doi.org/pzwr [21] Dundar S, Yaman F, Bozoglan A, Yildirim TT, Kirtay M, Ozupek MF, Artas G. Comparison of Osseointegraon of Five Diﬀerent Surfaced Titanium Implants. J. Craniofac. Surg. [Internet]. 2018; 29(7):1991-1995. doi: hps://doi. org/pmw5 5 of 6

Revista Cienﬁca, FCV-LUZ / Vol. XXXV UNIVERSIDAD DEL ZULIA Serbiluz Sistema de Servicios Bibliotecarios y de Información Biblioteca Digital Repositorio Académico [22] Calvo-Guirado JL, Satorres-Nieto M, Aguilar-Salvaerra A, Delgado-Ruiz RA, Maté-Sánchez de Val JE, Gargallo- Albiol J, Gómez-Moreno G, Romanos GE. Retracon Note: Inﬂuence of surface treatment on osseointegraon of dental implants: histological, histomorphometric and radiological analysis in vivo. Clin. Oral Invesg. [Internet]. 2024; 28(1):118. doi: hps://doi.org/pzws [23] Kreve S, Ferreira I, da Costa Valente ML, Dos Reis AC. Relaonship between dental implant macro-design and osseointegraon: a systemac review. Oral Maxillofac. Surg. [Internet]. 2024; 28(1):1-14. doi: hps://doi.org/ pzwt [24] Lee JW, Wen HB, Baula S, Akella R, Collins M, Romanos GE. Outcome aﬅer placement of tantalum porous engineered dental implants in fresh extracon sockets: a canine study. Int. J. Oral Maxillofac. Implants. [Internet]. 2015 [cited 05 Apr 2025]; 30(1):134-142. Available in: hps://goo.su/4Sps0 [25] Gasbarra E, Iundusi R, Perrone FL, Saturnino L, Taranno U. Densitometric evaluaon of bone remodelling around Trabecular Metal Primary stem: a 24-month follow- up. Aging Clin. Exp. Res. [Internet]. 2015; 27(Suppl 1):S69-S75. doi: hps://doi.org/pzww [26] Fraser D, Mendonca G, Sartori E, Funkenbusch P, Ercoli C, Meirelles L. Bone response to porous tantalum implants in a gap-healing model. Clin. Oral Implants Res. [Internet]. 2019; 30(2):156-168. doi: hps://doi.org/gx7ksq [27] Lee JW, Wen HB, Gubbi P, Romanos GE. New bone formaon and trabecular bone microarchitecture of highly porous tantalum compared to tanium implant threads: A pilot canine study. Clin. Oral Implants Res. [Internet]. 2018; 29(2):164-174. doi: hps://doi.org/ gts25s 6 of 6