## 4 Discussion
Moreover, certain implant design features allow peri-implant osteocytes to retain a less aged phenotype, despite highly advanced extracellular matrix maturation. Then, the physicochemical properties of the material can stimulate bone formation and remodeling by regulating the expression of RANKL (receptor activator of nuclear factor-kB ligand), RANK, and OPG (osteoprotegerin) from implant-adherent cells. Modulation of certain osteocyte-related molecular signaling mechanisms (e.g., sclerostin blockade) may enhance the biomechanical anchorage of implants [34]. Several studies have proposed that the morphological alterations on the implant surface characteristics can improve and accelerate the processes of healing of the bone tissue [10; 11; 12]. Thus, the present study had the aim to evaluate both implant models (conventional and new implant design) using the same conditions of the surface treatment, with and without treatment, to verify the importance of this factor in the early time period of osseointegration. The results showed that the macrogeometry of the implant had a much higher importance than the surface treatment at the proposed evaluation times (15 and 30 days). Regarding implant stability (ISQ), the G3 and G4 implants had a significant increase in relation to the implants of the G1 and G2 groups, i.e., at 15 days in the general average 19% higher and at 30 days, 25% bigger. In addition, comparing the evolution of ISQ within the same implant model between the 3 measured times, the groups G1 and G2 showed only a time 3 evolution in relation to time 1 (21%), whereas in the G3 and G4 groups the increase was 20% between time 1 and 2, and 25% between time 2 and 3, totaling a 45% increase between time 1 and 3. These data clearly demonstrate the benefit of healing chambers created in the new implant design. The removal torque measurement is a biomechanical analysis used to analyze the force of the interaction between the implant and bone tissue [35; 36], where the higher values to implant removal indicate a good interaction between the bone and implant surface [36], and a signal of good mineralization of the new bone formed. We compared the four groups proposed based on the two time points (15 and 30 days) after implantation, which was highly significant, and it is thus concluded that there is an important effect among the groups (\(p<0.05\)). Thus, as in the comparison made to ISQ values, when comparing the mean values of groups G1 and G2 with the groups G3 and G4, the latter presented a mean value 23% higher after 15 days and 48% higher after 30 days. When comparing the same groups between the times, the groups G1 and G2 had an increase of 21%, while the G3 and G4 groups showed a 47% increase in the removal torque of the implants. Again, the values indicate an acceleration in the process of osseointegration of the implants with the new design. Furthermore, the values compared statistically between the groups (G1 X G2 and G3 X G4) showed no statistically significant differences when evaluated implants were treated and not treated with the same macrogeometry for the time of 15 days and, showed no significant difference after 30 days. Figure 14: Schematic image to show the bone compression during the implant installation (red arrows) and decompression (green arrows) on the healing chambers. (**a**) Conventional threads design and (**b**) new threads design with healing chambers. Other studies have shown that implant design can present different osseointegration levels [36; 37], depending on its variables presented in the micro- and macrogeometry. Histologically, the values related to the quantity and quality of the bone healing around the implants are evaluated by the percentage of contact of bone to implant (BIC%) and percentage of occupation of the bone area fraction (BAFO%). In the present study, these both analyses showed similar values and evolution on the tested times (15 and 30 days) in all groups.