Histologic evaluation of guided vertical ridge augmentation around implants in humans

Int J Periodontics Restorative Dent. 1999 Oct;19(5):424-37.

Abstract

Recent experimental and clinical case reports demonstrated vertical ridge regeneration in atrophic posterior mandibles and maxillae. Although the results from these clinical cases are quite encouraging there is a lack of human histologic data on the newly regenerated tissue around commercially available titanium implants. The aim of the present study was to perform a qualitative and quantitative histologic analysis of the bone response to previously exposed implant threads after treatment with guided bone regeneration in a series of patients. A total of 30 Nobel Biocare implants were consecutively placed in 6 patients with partially edentulous mandibles. Of these implants, 6 were planned for removal after 1 year, whereas the remaining 24 implants were inserted to function as support for a fixed partial denture. The 6 experimental implants were intentionally allowed to protrude occlusally 5 to 7 mm from the bone crest without counter-sinking. The exposed implant threads were completely covered by autogenous bone chips. After a 12-month healing period the 6 experimental implants were removed with trephine burs. Bone-to-metal contact and bone density in the implant threads were measured. Clinically, all implants were stable and there was complete tissue fill of the space underneath the membranes. Histologically, a substantial amount of new bone had formed underneath the membrane in all cases. Histomorphometrically, there was a lower bone-to-metal contact percentage in the exposed compared to the nonexposed region in every case. With respect to bone density, there was a mean of 43.2% in previously exposed regions compared to 60.3% in previously nonexposed regions.

MeSH terms

  • Adult
  • Aged
  • Alveolar Bone Loss / surgery
  • Alveolar Process / anatomy & histology*
  • Alveolar Ridge Augmentation*
  • Bone Regeneration*
  • Dental Implantation, Endosseous / methods
  • Dental Implants*
  • Female
  • Guided Tissue Regeneration, Periodontal*
  • Humans
  • Male
  • Membranes, Artificial
  • Middle Aged
  • Osseointegration

Substances

  • Dental Implants
  • Membranes, Artificial