The strength characteristics of the cement-implant interface were evaluated for smooth-tapered, threaded, and porous-surfaced endodontic implants with the use of different cements. Specifically, tensile and torsional shear strengths were measured for zinc phosphate, polycarboxylate, glass-ionomer, silicophosphate, and AH-26 cements. The results indicated superior shear strength characteristics for threaded endodontic implants on axial loading. However, this strength was diminished when torsional forces were applied. Porous-surfaced endodontic implants showed strong resistance to both axial and torsional loading.

The study investigated the retentive strength of endodontic implants measured by forced removal (pull-out or push-out tests) as a function of implant design and cement type. Smooth-tapered, threaded, and an innovative porous-surfaced implant were evaluated. Specimens were cemented in single-rooted human teeth with five different cements: zinc phosphate, polycar☐ylate, glass ionomer, silicophosphate, or AH-26. The results indicated superior retention for the threaded and porous-surfaced implants, and stronger retention with glass-ionomer and AH-26 cements.

An endodontic implant model system was used to compare the effect of implant design on stabilization in bone. Specifically a porous-surfaced design was compared to conventional threaded and smooth-tapered endodontic implant designs. All implants were placed in immediate function thereby assessing the effect of early limited movement on the fixation achieved. A total of eighty-three endodontic implants were inserted in the mandibles of six adult mongrel dogs. Animals were sacrificed immediately after implantation and after 3, 6, and 12 months. Implants were evaluated by clinical and radiographic examination and after animal sacrifice by pull-out tests of the implant from the tissues, SEM examination of the pulled-out implants and, finally, histology. The pull-out test results indicated increasing shear strength with implantation time for the porous-surfaced implants in contrast to the gradual loss of fixation for the threaded implants and the continuous low shear strength for the smooth implants. Histological studies and SEM examination indicated the reason for these changes. Smooth implants became encapsulated by fibrous connective tissue from early post-implantation time periods. Threaded implants, although initially mechanically interlocked with bone, developed a fibrous connective tissue capsule that gradually thickened with time until, by 6 months, little mechanical interlock of bone and implant was present. It was assumed that this fibrous capsule thickening was caused by implant movement. The porous-surfaced implants, however, became stabilized by bone ingrowth and showed more extensive bone formation within the surface pores with time. It is concluded that for implants that are made functional immediately after implantation, as in this study, porous-surfaced implants can become strongly fixed by bone ingrowth, in contrast to conventional threaded or smooth-surfaced designs, thus presenting a more favourable long term prognosis.