This investigation developed experimental evidence for the influence of different surface energy states on tissue incorporation of biomedical materials. Implants of two smooth metals, each with three different surface energy states, were placed in the subdermal fascial plane of the backs of New Zealand White rabbits and were allowed healing times of 10 and 20 days. The implant surfaces were thoroughly characterized by physical-chemical criteria prior to surgical placement and again following removal from the tissue capsules generated by the host animals. Quantitative histopathologic analysis, using standard morphometric criteria, of the adjacent tissues revealed up to a threefold increase of fibroblastic-fibrocytic cells against the initially scrupulously cleaned, high-surface-energy materials. The cells were flattened and active, producing tenacious bonds through a thin pre-adsorbed protein-dominated "conditioning" film, that could be broken only by cohesive failure in the tissue itself. In contrast, the lower-surface-energy materials typical of standard dental implants were "walled off" by a cell-poor, nonadhesive capsule with a fibrous interface separated from a thicker "conditioning" film by a lipid-rich mucus zone. The advantages of proper surface treatment to favor the desired degree of biological adhesion are apparent.

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