AUTHOR=Wang Yarong , Gan Zekun , Lu Haibin , Liu Ziyi , Shang Peng , Zhang Jian , Yin Wuwei , Chu Hongxing , Yuan Renlei , Ye Yingxin , Chen Pei , Rong Mingdeng TITLE=Impact of High-Altitude Hypoxia on Early Osseointegration With Bioactive Titanium JOURNAL=Frontiers in Physiology VOLUME=Volume 12 - 2021 YEAR=2021 URL=https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2021.689807 DOI=10.3389/fphys.2021.689807 ISSN=1664-042X ABSTRACT=Objectives: This study aimed to investigate the osseointegration of different bioactive titanium surfaces under either normoxic or high-altitude hypoxic environments. Methods: Titanium implants were subjected to two different surface treatments: (1) sanding, blasting, and acid etching to obtain a rough surface, and (2) extensive polishing to obtain a smooth surface. Changes in the morphology, proliferation, and protein expression of osteoblasts on the rough and smooth surfaces were examined, and bone formation was studied through western blotting and animal-based experiments. Results: A hypoxic environment and rough surface of titanium implants promoted the osteogenic differentiation of osteoblasts and activated the JAK1/STAT1/HIF-1α pathway in vitro. The animal study revealed that following the insertion of implants, bone repair at high altitudes was slower than that observed at low altitudes (i.e., in plains) at 2 weeks, but that bone formation was not significantly different at 4 weeks. Conclusions: Our findings indicate that dentists should exert more caution with regard to early osseointegration in patients living in high-altitude environments and that the effect of hypoxia can be alleviated by using dental implants with a rough surface.