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Morphogenesis of the peri-implant mucosa: an experimental study in dogs.

Journal article
Authors Tord Berglundh
Ingemar Abrahamsson
Maria Welander
Niklaus P Lang
Jan Lindhe
Published in Clinical oral implants research
Volume 18
Issue 1
Pages 1-8
ISSN 0905-7161
Publication year 2007
Published at Institute of Odontology
Pages 1-8
Language en
Keywords Animals, Blood Coagulation, physiology, Collagen, Connective Tissue, growth & development, pathology, Dental Implants, Dental Materials, Dogs, Epithelial Attachment, growth & development, pathology, Epithelium, growth & development, pathology, Fibroblasts, pathology, physiology, Mandible, surgery, Models, Animal, Morphogenesis, physiology, Neutrophils, pathology, physiology, Periodontium, growth & development, pathology, Titanium, Wound Healing, physiology
Subject categories Biomaterials, Surgical research, Morphology, Periodontology


PURPOSE: The objective of the present experiment was to study the morphogenesis of the mucosal attachment to implants made of c.p. titanium. MATERIAL AND METHODS: All mandibular premolars were extracted in 20 Labrador dogs. After a healing period of 3 months, four implants (ITI Dental Implant System) were placed in the right and left sides of the mandible. A non-submerged implant installation technique was used and the mucosal tissues were secured to the conical marginal portion of the implants with interrupted sutures. The sutures were removed after 2 weeks and a plaque control program including daily cleaning of the remaining teeth and the implants was initiated. The animals were sacrificed and biopsies were obtained at various intervals to provide healing periods extending from Day 0 (2 h) to 12 weeks. The mandibles were removed and placed in the fixative. The implant sites were dissected using a diamond saw and processed for histological analysis. RESULTS: Large numbers of neutrophils infiltrated and degraded the coagulum that occupied the compartment between the mucosa and the implant during the initial phase of healing. At 2 weeks after surgery, fibroblasts were the dominating cell population in the connective tissue interface but at 4 weeks the density of fibroblasts had decreased. Furthermore, the first signs of epithelial proliferation were observed in specimens representing 1-2 weeks of healing and a mature barrier epithelium occurred after 6-8 weeks of healing. The collagen fibers of the mucosa were organized after 4-6 weeks of healing. CONCLUSION: It is suggested that the soft-tissue attachment to implants placed using a non-submerged installation procedure is properly established after several weeks following surgery.

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