What question did this study set out to answer?

The central aim was to assess how different implant designs and surface coatings affect bone regeneration over time.

July 3, 2026Open Access

Synergizing Macrogeometric Design and Nano-Hydroxyapatite Coatings to Enhance Early Implant Stability and Bone Maturation

ABAna Carolina Loyola BarbosaUniversidade de São Paulo RSRafaella da Cruz Polizelli ScannavinoUniversidade de São Paulo UCUislen CadoreUniversidade de São Paulo

Key Points

The central aim was to assess how different implant designs and surface coatings affect bone regeneration over time.
Twenty-four male rabbits received forty-eight implants for analysis at 3 and 8 weeks.
Biomechanical monitoring included final insertion torque and resonance frequency analysis.
High-resolution micro-computed tomography quantified the 3D intersection surface index and trabecular microarchitecture.
The Epikut and Unitite designs showed significant stability gains in clinical stability measurements at 3 weeks (p < 0.05).
Trabecular thickness increased significantly over time (p < 0.001), while other parameters remained statistically uniform across all models.
No significant differences in insertion torque were observed between macrogeometries (p = 0.557).

Abstract

Implant macrogeometry and surface microstructure represent fundamental pillars for accelerating and enhancing the quality of osseointegration. The objective of this study was to evaluate the synergistic effect of three distinct implant designs, Strong (hybrid with trapezoidal threads), Unitite (hybrid with healing chambers), and Epikut (hybrid with active double threads), associated with two surface configurations (dual acid-etched DAE and nanohydroxyapatite NanoHA) on bone regeneration at 3 and 8 weeks. Twenty-four male rabbits randomly received forty-eight implants in their tibiae, yielding an equal accounting of n = 12 animals per experimental healing period (3 and 8 weeks) to ensure a balanced longitudinal and structural analysis. Biomechanical monitoring included final insertion torque (IT) and resonance frequency analysis (ISQ) at installation and euthanasia, while high-resolution micro-computed tomography (µCT) quantified the 3D intersection surface index (IS/TS) and trabecular microarchitecture (BV/TV, Tb.Th, Tb.Sp, and Connectivity). Regarding insertion torque, no significant differences were observed between macrogeometries (p = 0.557), ensuring a standardized mechanical baseline for biological comparison. For clinical stability (ISQ), the Epikut and Unitite designs demonstrated significant stability gains as early as 3 weeks (p < 0.05). µCT data confirmed a progressive, time-dependent structural reorganization, presenting a significant increase in trabecular thickness (Tb.Th) over time (p < 0.001), while the overall bone volume fraction (BV/TV, p = 0.861) and IS/TS index (p = 0.774) maintained statistical uniformity across all studied models. In conclusion, implant macrogeometry and surface nanotopography exert a distinct, chronologically shifted synergy during osseointegration. Clinically, these findings dictate target-specific selection: macrogeometric innovations accelerate early secondary clinical stabilization, whereas bioactive NanoHA coatings optimize subsequent long-term trabecular thickening within the established peri-implant architecture.

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