Histology of Implant-covering Mucosa and Prognosis of Osseointegrated Implants

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Histology of Implant-covering Mucosa and Prognosis of Osseointegrated Implants
27 June 2003
Y. TOPLAR, B. MAYER, W. GROTH, and W. NIEDERMEIER, University of Cologne, Germany
IADR
Objectives: The aim of the study was to correlate histological findings of the implant covering mucosa with the long-term prognosis of osseointegrated implants. Method: 195 implants (Frialit 2 Type 45-03xx, Friadent, Germany) were placed in 97 patients and exposed using the punch technique (Biopsy Punch, 3-5mm, Stiefel, Germany) after an inconspicuous integration period of 3-6 months, and mucosa covering the fixtures was examined histologically. Gingivaformers (Type 45-14xx, Friadent) were mounted for 20¨±5 days, and following this standard abutments (Type 45- 21xx, Friadent) and temporarily fixed crowns were attached. 19¨±7 weeks after implant uncovering, permanent prostheses were employed. Up to 69 months after implant placement, following periimplant findings were ascertained prospectively: (a) pocket depth; (b) clinical attachment level; (c) radiographic findings. According to the clinical findings the implants were assigned to 5 groups: (0) control group without pathologic findings (n=114); (1) pathologic findings in one group (n=38); (2) pathologic findings in two groups (n=13); (3) pathologic findings in three groups (n=23); and (4) implant loss (n=7). The clinical classification (0-4) was correlated with histological findings of the mucosa samples taken. Results: ANOVA revealed a narrow correlation between clinical periimplant and histological findings of the previously taken mucosa samples; the number of eosinophils (p=0.000), lymphocytes (p=0.011), macrophages (p=0.000), plasma cells (p=0.001), foreign body giant cells (p=0.003), osteoblasts (p=0.000) and osteocytes (p=0.000) was significantly increased in group 3 and 4. In 2 cases, a suspicion of an allergic reaction against the implant material could not be excluded histologically. Conclusion: Histological examination of the mucosa tissues covering the fixture early indicates an unfavourable prognosis or possible loss of osseointegrated implants.