Hydroxyapatite and calcium phophate coatings on aluminium oxide orbital implants

Abstract Background: Hydroxyapatite and calcium phosphate have been used as bone graft substitutes as they facilitate and promote tissue ingrowth. We carried out a study to examine uncoated and coated aluminium oxide (alumina) spherical orbital implants and assess whether the coatings influence fibrovascular ingrowth. Methods: The aluminium oxide spheres (three coated with hydroxyapatite, three coated with calcium metaphosphate and three uncoated) were manufactured at the School of Materials Engineering, Yeungnam University, Kyongsan, Kyongbuk, Korea. The implants were examined macroscopically and with scanning electron microscopy and were analysed chemically by means of x-ray powder diffraction and x-ray fluorescence spectrophotometry. Implantation of three hydroxyapatite-coated, three calcium metaphosphate-coated and three uncoated aluminium oxide spheres was done in nine adult male New Zealand albino rabbits. Implant vascularization was evaluated at 4, 8 and 12 weeks by means of histopathological sectioning. Results: All three types of implant had multiple interconnected pores. The coatings increased the size of the trabeculae from 150 μm to 300 μm. As a result, the pores appeared slightly smaller but still ranged in size from 300 μm to 750 μm, compared to 400 μm to 800 μm in the uncoated implants. The coatings also increased the weight of the implants slightly. The implants were all strong mechanically. They were made up primarily of aluminium oxide. The coated implants contained significant amounts of calcium oxide (a contaminant). There was no clinical difference in the socket response between the three groups. Histopathologically, fibrovascularization occurred uniformly throughout each implant at 4, 8 and 12 weeks after implantation. Interpretation: The hydroxyapatite and calcium metaphosphate coatings did not appear to facilitate or inhibit fibrovascular ingrowth at 4, 8 and 12 weeks. Longer-term studies are need to determine whether the coatings play a role in long-term acceptance and retention of the implants.