Comparison of healed tissues adjacent to submerged and non‐submerged unloaded titanium dental implants. A histometric study in beagle dogs.

This study involved histometry of the healed tissues around submerged and nonsubmerged dental implants in beagle dogs. In a split‐mouth design, 19 submerged and 19 nonsubmerged commercially pure titanium implants, titanium plasma‐sprayed in the bone anchoring part and smooth in the transmucosal portion were placed in the mandibles of 6 dogs. Oral hygiene was performed 3 times weekly. After 3 months of healing, transmucosal abutments were inserted in the submerged implants. Six weeks after second stage surgery, the dogs were sacrificed and specimens obtained and processed for histology and histometry. Using a light microscope and a digitizing pad, the distance from implant top to mucosa border (DIM), the extent of epithelial downgrowth (ED), the attachment level (AL). the length of connective tissue contact (CTC) and the distance of the first coronal alveolar bone contact from the implant top (DIB) were measured at the mesial and distal aspects. Means+standard deviations for submerged and nonsubmerged implants were calculated, with the dog being the unit of measure. No statistically significant differences between submerged and nonsubmerged implants here found for DIM, CTC and DIB. However, significant differences were observed for ED and AL. This study in beagle dogs indicates that the apical extension of the peri‐implant epithelium is significantly greater and the attachment level significantly lower adjacent to submerged implants with second‐stage transmucosal abutments than in nonsubmerged, one‐stage implants.     

非埋植型与埋植型牙种植体骨界面改建的X线观察

目的 比较非埋植型与埋植型两种不同种植方式种植体－骨界面组织变化的异同。方法 选用成年杂种犬8只，在其下颌分别植入埋植型与非埋植型种植体，分不同时期处死动物，采用X线对非埋植型与埋植型种植体－骨界面愈合过程进行动态观察，比较两者者界面改建的异同。结果 X线观察1、2、4周非埋植型和埋植型种植体－骨界面新骨形成的速度与骨性结合的程度均无明显差异。12周时，非埋植型和埋植型种植体与骨组织均紧密接触，但非埋植型种植体颈部观察到牙槽骨轻微吸收现象。结论 非埋植型种植体尽管植入后基桩在整个愈合过程中承受了一定的咬合力，但它能与埋植型种植体一样获得良好的骨结合。     

Clinical and histologic evaluation of submerged and nonsubmerged hydroxyapatite-coated implants: a preliminary study in dogs

A clinical and histologic study was performed to evaluate the differences in the healing of submerged and nonsubmerged hydroxyapatite-coated 2-piece implants. Three foxhounds were used for this evaluation. Mandibular premolars 1, 2, 3, and 4 were extracted. Three months later, 2 submerged implants were placed on one side of the mandible, and 2 nonsubmerged implants were placed on the other side of the mandible. After 3 months of healing, the submerged implants were exposed, and a third implant was placed on each side of the mandible in a nonsubmerged procedure. Clinical parameters were recorded, the animals were sacrificed 6 months after placement of the first implants, and histologic and histometric analyses were performed. Results of the evaluation of the clinical parameters showed only minor differences among the different treatment groups. Regarding the percentage of bone-to-implant contact of the different treatment groups, the submerged implants showed a bone-to-implant contact of 63.4%, the nonsubmerged implants showed 70.3% contact, and the late nonsubmerged implants demonstrated a bone-to-implant contact of 58.7%. The average distance from the implant neck to the first bone-to-implant contact (fBIC) for submerged implants was 0.58 mm, for nonsubmerged implants it was 1.09 mm, and it was 1.13 mm for late nonsubmerged implants. The vertical distance between the gingival margin and the apical extent of the junctional epithelium (aJE) varied from 1.14 mm to 1.28 mm in the different groups. The distance from the aJE to fBIC was 1.00 mm for the submerged group, 1.08 mm for the nonsubmerged group, and 1.00 mm for the late nonsubmerged group. Generally, it can be concluded that the clinical and the histologic behavior of submerged or nonsubmerged 2-piece implants utilized in this experiment do not differ.     

The relationship of bone resorption around dental implants to abutment design: a preliminary 1-year clinical study

The influence of abutment design on bone resorption around immediately loaded and osseointegrated implants used to support fixed partial prostheses was investigated in a 1-year study. One hundred ten implants were placed in 24 anterior partially edentulous maxillae. The probing depths of each implant were measured 6 and 12 months after abutment placement and analyzed statistically. Total probing depth was 1.75 ± 0.75 mm. There were significant differences between non- and submerged implants with angled abutments and between submerged implants with straight and angled abutments. No significant differences were observed between non- and submerged implants with straight abutments and between nonsubmerged implants with straight and angled abutments. Bone resorption around dental implants is influenced by the abutment design and the associated implantation protocol.     

Treatment of ligature-induced peri-implantitis defects by regenerative procedures. Part II: A histometric study in dogs

The purpose of this study was to evaluate, by histometric analysis, re-osseointegration following treatment of ligature-induced peri-implantitis in dogs. Five dogs were used in this study. Their mandibular premolars (P2, P3 and P4) were first removed. After 3 additional months of healing, two titanium implants were placed on each side of the mandible. After 3 months, the abutment connection was performed and experimental peri-implantitis was induced by placing cotton ligatures in a submarginal position. Ligatures and abutments were removed after one month and the peri-implant bone defects were randomly assigned to one of the treatments: debridement, debridement plus guided-bone regeneration, debridement plus mineralized-bone graft, and debridement plus guided-bone regeneration associated with mineralized-bone graft. Five months post-treatment, the degree of bone contact with the implant surface and the bone area within the threads were measured in 12 threads, the 6 most coronal at each side of each implant. One-way analysis of variance did not reveal statistically significant differences between the treatment modalities (p > 0.05). Within the limits of the present study, it can be concluded that there is a limited possibility of re-osseointegration around implant surfaces previously exposed by ligature-induced peri-implantitis.     

非埋植型与埋植型牙种植体骨界面改建的骨组织形态计量学研究

目的观察非埋植型与埋植型两种不同种植方式之间种植体—骨界面结合动态变化的异同。方法选用成年杂种犬8只，在其下颌分别植入埋植型与非埋植型种植体，分不同程期处死动物，采用骨组织形态计量学方法对非埋植型与埋植型种植体—骨界面愈合过程进行动态观察，比较了两者骨界面改建的异同，从定量的角度分析其变化的异同。结果非埋植型种植体骨结合率均略低于埋植型种植体，但它们之间无统计学差异。尽管非埋植型种植体植入后基桩在整个后基桩在整个愈合过程中承受了一定的咬合力，但它能与埋植型种植体一样获得良好的骨结合。结论埋植型与非埋植型种植体其新骨形成的速度与骨性结合的程度两者之间无明显差异。采用骨组织形态计量学方法定量、动态地研究种植体—骨界面结合动态变化有一定的应用价值。     

Beagle犬埋植型与非埋植型种植义齿骨界面改建的短期X线观察

目的：观察比较埋植型与非埋植型种植体在义齿修复受载后，其种植体一骨界面组织变化的异同。方法：选用纯系动物Beagle犬8只，在其下颌分别植入埋植型与非埋植型种植体，采用固定金属全冠行种植义齿修复，分不同程期处死动物。采用X线对埋植型与非埋植型种植体一骨界面改建过程进行动态观察，比较两者之间的异同。结果：X线显示各个程期所有埋植型和非埋植型种植体周围均无透光区，骨质密度和骨小梁的排列与宿主骨基本一致。非埋植型种植体颈部牙槽骨显示轻微的水平吸收。埋植型和非埋植型种植体之间无明显差异。结论：非埋植型种植体尽管植入后基桩在整个愈合过程中承受了一定的咀嚼力，但它能与埋植型种植体一样获得良好的骨结合。埋植型和非埋植型种植义齿受载后其界面的改建之间无显著差异。     

Influence of abutment connections and plaque control on the initial healing of prematurely exposed implants: an experimental study in dogs

BACKGROUND: Spontaneous early implant exposure is believed to be harmful, resulting in early crestal bone loss around submerged implants. The purpose of this study was to examine the influence of abutment connections and plaque control on the initial healing of prematurely exposed implants in the canine mandible. METHODS: Bilateral, edentulated, flat alveolar ridges were created in the mandible of 10 mongrel dogs. After 3 months of healing, two implants were placed on each side of the mandible following a commonly used two-stage surgical protocol. Implants on each side were randomly assigned to one of two procedures: 1) connection of a cover screw to the implant and removal of the gingiva to expose the cover screw; and 2) connection of a healing abutment to the implant so that the coronal portion of the abutment remained exposed to the oral cavity. In five dogs (plaque control group), meticulous plaque control was performed. In the other five dogs (no plaque control group), plaque was allowed to accumulate. At 8 weeks post-implantation, microcomputed tomography was performed at the implantation site to measure bone height in the peri-implant bone. RESULTS: The plaque control group had greater vertical alveolar ridge height (9.7 +/- 0.5 mm) than the group without plaque control (7.4 +/- 0.7 mm; P <0.05). In the plaque control group, the average bone height was greater with the abutment-connected implant (10.1 +/- 0.5 mm) than with the partially exposed implant (9.3 +/- 0.5 mm; P <0.05). In the group without plaque control, the average bone height was greater with the partially exposed implant (8.2 +/- 0.6 mm) than with the abutment-connected implant (6.5 +/- 0.7 mm; P <0.05). CONCLUSION: These results suggest that the placement of healing abutments and meticulous plaque control may limit bone loss around submerged implants when implants are partially exposed.     

Osseointegration of titanium implants following guided bone regeneration using expanded polytetrafluoroethylene membrane and various bone fillers

The purpose of this study was to evaluate the percentage of bone-to-implant contact following guided bone regeneration using expanded polytetrafluoroethylene (e-PTFE) membranes and various bone fillers in a beagle dog model. A staged approach was used for initial bone regeneration of surgically created defects and subsequent implant placement in newly regenerated ridges. Three months after bilateral extraction of the mandibular premolars and first molars, rectangular, distal-extension defects that included the entire width of the ridge buccolingually were surgically created in the alveolar processes. All defects were covered with an e-PTFE membrane, and several bone fillers were placed, in a randomized fashion, under the membrane: autogenous bone, demineralized freeze-dried bone, anorganic bovine bone, tricalcium phosphate granules, and collagen sponge. One site in each animal was treated with e-PTFE barrier membrane alone as control. Following an 8-month healing period, nonsubmerged titanium implants (36 total) were placed in regenerated bone following membrane removal. Three months later, the animals were sacrificed, and nondecalcified buccolingual sections were evaluated histometrically for bone-to-implant contact. All sites demonstrated high percentages (50% to 65%) of bone-to-implant contact, with no significant differences across the various treatment groups. In addition, all tested bone fillers formed a complex that supported and maintained the osseointegrated implants in a healthy state, with no apparent signs of peri-implantitis. Using a staged approach, the present study provided histologic and histometric evidence that implants placed in entirely regenerated bone can achieve and maintain osseointegration, regardless of the type of bone fillers used.     

Resolution of ligature-induced peri-implantitis lesions in the dog

Abstract The present experiment in the Labrador dog was performed to study tissue alterations that occurred in a peri-implantitis lesion following ligature removal. The study was carried out in 5, 1-year old Labrador dogs. The mandibular right and left 1st molars and 4th and 3rd premolars were extracted to establish recipient sites for implants. After 3 months of healing, 4 titanium fixtures, 2 in each jaw quadrant, were installed and abutment connection carried out in a 2nd stage procedure after another 3 months. After a 6-month period of healing, cotton floss ligatures were placed in a submarginal position around the neck of the fixture abutments. The ligatures were forced into a position “apical” of the margin of the peri-implant mucosa and secured. When the tissue destruction after 4–6 weeks was found to amount to about 25% of the original bone height at each individual implant, the ligatures were removed. 2 dogs were sacrified 1 month and 3 dogs 3 months after ligature removal. The animals were perfused with a fixative and block biopsies were obtained from the implant sites. The biopsies were prepared for histometric and morphometric analyses. The results from the clinical examinations and the microscopic analyses of the peri-implant tissues revealed that: (i) 1 month after ligature removal, an active, destructive inflammatory lesion was present in the soft and mineralized tissues adjacent the implants; while (ii) 2 months later, this lesion at most implant sites had become resting and encapsulated, was confined to the connective tissue adjacent to a pocket epithelium, and was separated from the bone surface by a dense collar of fibrous connective tissue. In 1 of the 3 dogs that were monitored for 3 months, however, 3 out of the 4 implants installed exhibited continued loss of bone, became unstable and were lost between the 10- and 12-week examination interval. The remaining peri-implant tissue at the 4th and remaining implant in this animal was found to harbor an active lesion that involved osteoclastic activity on the surface of the bone crest.     

Absorbable versus nonabsorbable membranes and bone grafts in the treatment of ligature-induced peri-implantitis defects in dogs: a histometric investigation.

The purpose of this study was to histometrically evaluate an absorbable collagen membrane (Bio-Gide) and a nonabsorbable polytetrafluoroethylene membrane (PTFE), associated with or without bone grafts, regarding "re-osseointegration" after treating ligature-induced peri-implantitis defects in dogs. All mandibular premolars were removed from five 2-year-old mongrel dogs. After 3 months of healing, 3 titanium implants were placed on each side of the mandible. Experimental peri-implantitis was induced with ligatures after abutment connection. Ligatures and abutments were removed after 1 month and the bone defects were randomly assigned to one of the following treatments; debridement alone (DB), debridement plus PTFE membrane associated with mineralized bone graft (Bio-Oss) (GBR+BG-I), debridement plus collagen membrane (Bio-Gide) associated with mineralized bone graft (GBR+BG-II), debridement plus PTFE membrane (GBR-I), debridement plus collagen membrane (GBR-II), or debridement plus mineralized-bone graft (BG). The dogs were sacrificed after 5 months. Data analysis did not reveal significant differences among the treatments regarding the percentage of bone-to-implant contact ("re-osseointegration") within the limits of the threads of the implant (P = .997). Thus, in the treatment of peri-implantitis, debridement alone as well as grafting alone had the same effect as did either membrane.     

Crestal bone changes around titanium implants: a methodologic study comparing linear radiographic with histometric measurements

Generally, endosseous implants can be placed according to a nonsubmerged or a submerged technique and in 1-piece or 2-piece configurations. Recently, it has been shown that peri-implant crestal bone reactions differ significantly radiographically as well as histometrically under such conditions and are dependent on a rough/smooth implant border in 1-piece implants and on the location of a microgap (interface) between the implant and the abutment/restoration in 2-piece configurations. The purpose of this study was to evaluate whether standardized radiography as a noninvasive clinical diagnostic method correlates with peri-implant crestal bone levels as determined by histometric analysis. Fifty-nine implants were placed in edentulous mandibular areas of 5 foxhounds in a side-by-side comparison in both submerged and nonsubmerged techniques. Three months after implant placement, abutment connection was performed in the submerged implant sites. At 6 months, all animals were sacrificed, and evaluations of the first bone-to-implant contact (fBIC), determined on standardized periapical radiographs, were compared to similar analyses made from nondecalcified histology. It was shown that both techniques provide the same information (Pearson correlation coefficient = 0.993; P < .001). The precision of the radiographs was within 0.1 mm of the histometry in 73.4% of the evaluations, while the level of agreement fell to between 0.1 and 0.2 mm in 15.9% of the cases. These data demonstrate in an experimental study that standardized periapical radiography can evaluate crestal bone levels around implants clinically accurately (within 0.2 mm) in a high percentage (89%) of cases. These findings are significant because crestal bone levels can be determined using a noninvasive technique, and block sectioning or sacrifice of the animal subject is not required. In addition, longitudinal evaluations can be made accurately such that bone changes over various time periods can be assessed. Such analyses may prove beneficial when trying to distinguish physiologic changes from pathologic changes or when trying to determine causes and effects of bone changes around dental implants.     

Tissue reactions to abutment shift: an experimental study in dogs

Background: Standard protocols for the clinical use of dental implants often include the placement of healing abutments prior to standard or custom‐made abutments. The tissue response to a single shift from a healing abutment to a permanent abutment has not been studied. Purpose: The aim of the present experiment was to study tissue reactions that may occur following the removal of a healing abutment and the placement of a permanent abutment. Materials and Methods: In six beagle dogs, all mandibular premolars were extracted. Three months later three fixtures of the Astra Tech Implants Dental System (Astra Tech AB, Mölndal, Sweden) were installed in each edentulous premolar region. An additional 3 months later, the first abutment connection was performed. In two sites on each side of the mandible, healing abutments were placed; in the remaining site, a Uni‐abutment (Astra Tech AB) was used. The two healing abutments were removed 2 weeks later, and one Uni‐abutment and one prepable abutment were placed. A plaque‐control period was initiated, and 6 months later block biopsies were obtained. The biopsies were prepared for histometric and morphometric examination. Radiographs were obtained at fixture placement, 2 weeks after the first abutment connection, and 6 months later. Results: The length of the barrier epithelium, the height of the connective tissue attachment, and the level of the marginal bone did not differ between the three abutment groups. The major part of the radiographic bone loss during the experiment took place prior to or immediately after abutment connection; only small bone level alterations occurred during the subsequent 6‐month period. Conclusions: The shift from a healing abutment to a permanent abutment resulted in the establishment of a transmucosal attachment, the dimension and quality of which did not differ from those of the mucosal barrier formed to a permanent abutment placed during a second‐stage surgery.     

A radiographic evaluation of bone healing around submerged and non-submerged dental implants in beagle dogs

BACKGROUND: The rehabilitation of the oral cavity with dental implants has become a predictable treatment modality. However, there have been only a few direct comparisons evaluating the submerged and nonsubmerged placement techniques. The purpose of this study was to characterize radiographic peri-implant bone changes following the insertion of submerged and nonsubmerged implants in the beagle dog. METHODS: At the end of the extraction healing phase, 19 submerged and 19 nonsubmerged implants were randomly placed in a split-mouth study design and observed over an 18-week period. For submerged implants, a second stage surgery and transmucosal abutment attachment was performed at week 12. Standardized dental radiographs taken at baseline, week 12, and week 18 were used to measure peri-implant bone changes. The radiographs were analyzed with a simple computer assisted method. RESULTS: A total of 43 standardized radiographs were exposed to evaluate the 38 implants. During the study period, all submerged and nonsubmerged implants demonstrated peri-implant bone loss. At baseline, both submerged and nonsubmerged implants had similar bone levels (P > or = 0.05). When the mean peri-implant bone levels for submerged and nonsubmerged implants were compared from baseline to week 12, nonsubmerged implants had a significantly greater amount and rate of bone resorption than submerged implants (P < or = 0.05). Following week 12, the initially submerged implant had a significantly higher rate and amount of peri-implant bone loss than the nonsubmerged implants (P < or = 0.05). However, by the end of the study period, week 18, both submerged and nonsubmerged implants had comparable bone levels (P > or = 0.05). CONCLUSIONS: The study indicates that, although the temporal patterns of peri-implant bone resorption differed, there were no differences between submerged and nonsubmerged implants in the overall amount and rate of peri-implant bone loss.     

Influence of different treatment approaches on non-submerged and submerged healing of ligature induced peri-implantitis lesions: an experimental study in dogs

OBJECTIVE: [corrected] The aim of the present study was to evaluate non-submerged and submerged healing of ligature induced peri-implantitis in dogs. MATERIAL AND METHODS: Peri-implantitis was induced by ligature placement in five beagle dogs (n = 30 implants). The defects were randomly and equally allocated in a split-mouth design to either closed treatment + non-submerged healing (CNS), or open treatment + submerged healing (OS) using an Er:YAG laser (ERL), an ultrasonic device (VUS), or plastic curettes + local application of metronidazole gel (PCM), respectively. The animals were sacrificed after 3 months. Clinical, radiological and histological (e.g. new bone-to-implant contact (BIC)) parameters were assessed. RESULTS: All treatment procedures resulted in statistically significant improvements of all clinical parameters at both CNS and OS implants. Radiological improvements were merely observed at OS implants. Histomorphometrical analysis revealed that all CNS implants exhibited comparable low amounts of new BIC (1.0-1.2%), while mean BIC was statistically significant higher in the respective OS groups [ERL (44.8%), PCM (14.8%), VUS (8.7%)]. CONCLUSION: Within the limits of the present study, it was concluded that (i) OS improved the outcome of treatment in comparison with CNS and (ii) ERL seemed to be more suitable to promote re-osseointegration than PCM and VUS.     

Beagle犬的埋植型与非埋植型种植义齿骨组织界面改建的组织形态学定量测定

目的：研究对比埋植型与非埋植型种植体在义齿修复受载后，种植体-骨组织界面动态变化的异同、方法：选用纯系动物Beagk犬8只，在其下颌分别植入埋植型与非埋植型种植体，采用固定金属全冠行种植义齿修复，不同程期处死动物。采用组织形态学定量测定的方法．对埋植型与非埋植型种植义齿种植体-骨界面改建过程进行动态观察，比较两者骨界面改建的异同，从定量的角度分析其变化的异同、结果：埋植型种植义齿修复受载后2、8、12周，骨结合率略高于非埋植型种植义齿，而4周则略低于非埋植型种植义齿，但它们之间无统计学差异。结论：非埋植型种植体尽管植入后基桩在整个愈合过程中承受了一定的咬合力，但它能与埋植型种植体一样获得良好的骨结合。埋植型和非埋植型种植义齿受载后，其界面的改建之间无显著差异。     

Regeneration procedures in immediate transmucosal implants: an animal study

The aim of the present study was to evaluate bone regeneration around nonsubmerged implants placed immediately in extraction sites in the canine mandible using a combination of synthetic hydroxyapatite (HA) and collagen membranes. Ten beagle dogs were used in this study. After the second and third mandibular premolars were extracted, hollow-screw implants were placed in the distal extraction sockets. In each animal, one site received no treatment (control site), while other defects received randomly 1 of the following treatments: grafting with porous HA in the peri-implant region, collagen membrane adapted to the implant cervical collar covering the peri-implant defects, or a combination of the 2 treatments, i.e., HA grafting and membrane placement. After 4 months of healing, block biopsies were obtained and prepared for histologic analysis using the cutting-grinding technique. The histometric evaluation took into account the number of integrated screw threads, the extent of bone-to-implant contact, and the density of peri-implant bone. At sites covered by membrane alone or by membrane and HA, the number of integrated threads was statistically higher than sites treated only with HA. The extent of bone-to-implant contact was significantly different between treatments. However, the use of bioabsorbable materials did not significantly enhance peri-implant bone regeneration in immediate implantation.     

Direct loading of Nobel Direct and Nobel Perfect one-piece implants: a 1-year prospective clinical and radiographic study

OBJECTIVES: The aim of this prospective study was to evaluate the Nobel Direct and Nobel Perfect one-piece implants (OPIs) when used for immediate function. MATERIAL AND METHODS: Forty-eight patients were provided with 115 OPIs for loading with a provisional crown or a bridge within 24 h and followed for at least 12 months with clinical and radiographic examinations. A group of 97 patients previously treated under identical conditions by the same team with 380 two-piece implants (TPIs) for immediate loading in the mandible and maxilla served as the reference group. RESULTS: Six (5.2%) OPIs failed during the follow-up due to extensive bone loss. Five (1.3%) implants failed in the reference group. After 1 year, the mean marginal bone loss was 2.1 mm (SD 1.3) for OPIs and 0.8 mm (SD 1) for TPIs. 20% of OPIs showed more than 3 mm of bone loss compared with 0.6% for TPIs. When compensating for vertical placement depth, OPIs still showed a lower marginal bone level and thus more exposed threads than TPIs. Depending on the criteria used, the success rate for OPIs was 46.1% or 72.2% compared with 85% or 91.6% for TPIs. CONCLUSIONS: The Nobel Direct and Nobel Perfect OPIs show lower success rates and more bone resorption than TPIs after 1 year in function. Factors such as implant design, insertion depth, rough surface towards the mucosa, in situ preparation and immediate loading may have an influence on the clinical outcome.     

Clinical and radiographic evaluation of submerged and nonsubmerged implants in monkeys

The purpose of this study was to compare the healing response of submerged implants with that of nonsubmerged implants and to determine the influence of oral hygiene procedures on the initial healing response adjacent to nonsubmerged implants. Radiographs demonstrated direct bone-implant contact of submerged and nonsubmerged implants. No significant differences in bone-implant scores were recorded between the submerged and nonsubmerged implants with oral hygiene. Oral hygiene procedures during healing had a positive influence on the gingival status and marginal bone height adjacent to nonsubmerged implants.     

The effect of insulin therapy on osseointegration in a diabetic rat model.

As patients become edentulous, dental implants have been one treatment alternative. Although studies indicate that dental implants inserted in healthy patients have been successful, their placement in the diabetic patient remains controversial. The purpose of this study utilizing histometric parameters compares the course of osseous healing around endosseous implants in normal non-diabetic and insulin controlled diabetic rats. Diabetes was induced by a single intraperitoneal injection of streptozotocin. Blood glucose was monitored by the glucose-oxidase method and controlled with daily insulin injections. Sterile custom fabricated commercially pure solid cylinder titanium implants, with a titanium plasma-sprayed surface were placed in the femora of each animal. The results indicate that insulin therapy was able to upregulate the formation of bone around implants inserted in the streptozotocin-induced diabetic rat model. However, histometric parameters utilized indicated that although the total quantity of bone formation was greater in the insulin controlled group, there was significantly less bone-to-implant contact in the insulin controlled diabetic group as compared to normal non-diabetic controls.