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Implant Denture Histology: Gross and Microscopic Studies of a Human Mandible with a 12-Year Subperiosteal Implant Denture

1970; Elsevier BV; Volume: 14; Issue: 1 Linguagem: Inglês

10.1016/s0011-8532(22)01850-x

1558-0512

Roy L. Bodine, CUVE I. MOHAMMED,

Periodontal Regeneration and Treatments

A mandible that had supported a subperiosteal implant denture for more than 12 years when the patient died of unrelated causes was studied histologically in serial sections. The following conclusions were drawn. Epithelium did not grow downward along the primary abutment struts to encapsulate the peripheral frame. The connective tissue in contact over, around, and under the buried metal was modified into flattened compressed fibers and cells with elongated nuclei. Although the crevice around an implant abutment somewhat resembled a normal tooth crevice, the implant crevice, which was lined with thin epithelium, extended under the abutment and had progressed only 2 or 3 mm. along the metal strut from the penetration in more than 12 years. Inflammatory cells in the tissue adjacent to the epithelialized implant abutment crevice were comparable to the inflammatory cells generally present around the gingival sulci of natural teeth. Every metal exposure, whether a primary exposure for the four implant abutments or an accidental secondary exposure of the substructure frame, should be regarded as a possible source of beginning epithelial downgrowth. No significant bone resorption, "settling," or loss of vertical dimension occurred in this patient in 12 years. There was a tendency for bone to grow over the implant periphery on the lingual, especially in the mandibular torus area. Certainly these findings, based on study of a single patient, indicate that a subperiosteal implant denture can be remarkably well tolerated over a 12-year period with no histologic evidence of damage to the approximating or adjacent tissues. Patients with long-standing implant dentures seldom die under conditions which make it possible to recover their mandibles for scientific study. Maximum use must be made of such material as becomes available to advance the scientific knowledge of conditions around the buried substructure of the implant denture.