Impact of dental implant insertion method on the periimplant epithelial seal: Experimental study on dogs

Abstract

Background/Aim. There is a controversial opinion among implantologists on the method of dental implantation that provides more favourable response of soft and bone tissues. The aim of this study was to pathohistologicaly compare the influences of one- and two-phase implant surgical methods on the periimplant epithelial tissues. Methods. The experiment was performed on 10 dogs. Eight weeks following tooth extractions implants were inserted using one phase method on the right side of the mandible, and two-phase method on the left one. Three months after implantation the animals were sacrificed. Contact regions of epithelial and subepithelial tissues and implants were pathohistologicaly examined, the elements of analysis were scored and compared. Results. Epithelial tissue was not found in the two samples of one-phase implants, while in the remainder of samples the structure of basal membrane was preserved, massive inflammatory infiltrate was found in one, and partial necrosis was found in three samples. Epithelial tissue was not found in the three samples of two-phase implants, in three samples the structure of basal mambrane was intact, while in three remained samples the membrane could not be detected; moderate inflammatory infiltrate was found in four samples and massive inflammatory infiltrate in both two remained samples; tissue necrosis, which was observed in the half of the samples, was complete. In subepithelial gingival tissues around one-phase implants the number of blood vessels was increased in three samples, accompanied by the thickening and dilatation of vascular walls, proliferation of blood elements, altered vascular walls and inflammatory cell infiltrate was found in four samples. Conclusion. On the base of the analized characteristics of epithelial and subepithelial tissues in contact with dental implants, one-phase method of implantation showed a more favorable tissue response.Uvod/Cilj. Postoje oprecna misljenja medju implantolozima o tome koja metoda implantacije dovodi do povoljnije reakcije mekog i kostanog tkiva. Cilj rada bio je da se patohistoloskom analizom uporede uticaji jednofazne i dvofazne metode ugradnje dentalnih implantata na periimplantatno epitelno tkivo. Metode. Eksperiment je obavljen na grupi od 10 pasa. Osam nedelja posle ekstrakcije zuba psima su ugradjeni implantati, sa desne strane jednofaznom, a sa leve dvofaznom metodom. Tri meseca posle implantacije vrseno je zrtvovanje zivotinja. Patohistoloski je analizirana zona kontakta epitelnog i subepitelnog tkiva i implantata, a posmatrani elementi su skorirani i uporedjeni. Rezultati. U dva uzorka oko jednofaznih implantata nije bio prisutan epitel, a u svim ostalim, struktura bazalne membrane bila je ocuvana. Bogat inflamatorni infiltrat nadjen je u jednom, a delimicna nekroza u tri uzorka. U tri uzorka oko dvofaznih implantata nije bio prisutan epitel, struktura bazalne membrane bila je ocuvana u tri uzorka, dok u preostala tri nije se mogla uociti na preparatu; umeren inflamatorni infiltrat nadjen je u cetiri uzorka, a bogat infiltrat u po dva uzorka; nekroza tkiva, nadjena u polovini uzoraka, bila je kompletna. U subepitelnom tkivu gingive oko jednofaznih implantata nadjeno je povecanje broja krvnih sudova u tri uzorka uz zadebljanje i dilataciju zidova krvnih sudova, prepunjenost krvnim elementima i prisustvo inflamatornog infiltrata. U subepitelnim tkivima gingive oko dvofaznih implantata u sest uzoraka bio je povecan broj krvnih sudova uz prepunjenost krvnim elementima, izmenjen izgled zidova i prisustvo inflamatornog celijskog infiltrata u po cetiri uzorka. Zakljucak. Na osnovu analiziranih osobina epitelnog i subepitelnog tkiva u kontaktu sa dentalnim implantatima, jednofazna implantacija ima povoljniju reakciju analiziranog tkiva.