title: Retrieval analyses of implanted biomaterials: light microscopic and scanning electron microscopic analyses of implants retrieved from humans.
abstract: We report analyses obtained from 135 implant cases retrieved from humans and submitted to the American Academy of Implant Dentistry Research Foundation--Medical College of Georgia Implant Retrieval Center. The undecalcified samples were embedded in polymethyl-methacrylate and examined with scanning electron microscopy and with routine light via polarized or Nomarski microscopy. Cases included both orthopedic and dental implants as well as entire mandibles obtained at autopsy. Significant numbers of submitted implants had substantial amounts of adhered bone, which permitted evaluation of human bone remodeling to osseointegrated implants. These implants failed because of implant fracture. As has been observed in animal studies, an interdigitating canaliculi network provided communication between interfacial osteocytes and osteocytes deeper within the remodeled osteonal and trabecular bone. Significant numbers of osseointegrated fractured hydroxyapatite-coated dental implants demonstrated the adequate serviceability of these implants prior to biomaterial fracture. In contrast, the hydroxyapatite coating was dissociated from retrieved orthopedic implants, leading to extensive cup loosening and case failure. Caution is advised for the use of hydroxyapatite-coated acetabular implants. This study therefore underscores the need for evaluation of failed human dental and orthopedic implants. Correlations can be drawn between human retrieval and experimental animal studies.
authors.affiliation: Department of Surgery, Medical College of Georgia, Augusta 30912-4030, USA.
authors.forename: R S
authors.initials: RS
authors.lastname: Corpe
authors.forename: D E
authors.initials: DE
authors.lastname: Steflik
authors.forename: T R
authors.initials: TR
authors.lastname: Young
authors.forename: M R
authors.initials: MR
authors.lastname: Wilson
authors.forename: C A
authors.initials: CA
authors.lastname: Jaramillo
authors.forename: M
authors.initials: M
authors.lastname: Hipps
authors.forename: A
authors.initials: A
authors.lastname: Sisk
authors.forename: G R
authors.initials: GR
authors.lastname: Parr
mesh_terms: D000368:Aged; D020099:Coated Materials, Biocompatible / Q000009:adverse effects*; D015921:Dental Implants; D019232:Dental Restoration Failure; D020878:Device Removal; D017886:Durapatite / Q000009:adverse effects*; D019544:Equipment Failure Analysis; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D016348:Osseointegration / Q000187:drug effects; D010780:Photogrammetry; D011475:Prosthesis Failure; D013499:Surface Properties
chemical_list: D020099:Coated Materials, Biocompatible; D015921:Dental Implants; D017886:Durapatite