A histomorphometric evaluation of factors influencing the healing of bony defects surrounding implants.
OBJECTIVE
The authors' aim was to perform a histomorphometric study of the healing of bone defects created adjacent to titanium and hydroxyapatite (HA) -coated implants and covered with either a resorbable or a nonresorbable membrane in combination with different filler materials and to evaluate to what degree coating, membrane, and/or filler influenced the healing of the defects.


METHODS
Posterior teeth were extracted from the mandibles of 10 baboons, and 12 implants were placed in each animal in the edentulous areas. The implants were either titanium or HA-coated, the membranes were either Vicryl, Gore-Tex, or Resolut, and the filler was either demineralized freeze-dried bone (DFDB), autogenous bone, or Biocoral. The implants were observed for either 3, 6, 9, 12, or 18 months. The volume of newly generated tissue and the relative contribution of bone, marrow, and filler were evaluated, as was relative extension of resorption, formation, and quiescent surface.


RESULTS
The results indicated that autogenous bone is still the gold standard, but both the DFDB and Biocoral compared favorably to it. Both filler materials were being gradually replaced by bone; this process was not yet finished at 18 months postsurgery.


CONCLUSIONS
Since even the sterilization of DFDB cannot exclude the possibility of a disease transmission, it is important to find an appropriate substitute. Both filler and membranes contributed to the re-establishment of the original volume; better results were achieved with the Vicryl and Gore-Tex membranes than with the Resolut. Biocoral can be considered an effective material.


CONCLUSIONS
A bony defect is not necessarily a contraindication for the placement of an implant. (More than 50 references.)
University of Aarhus, School of Dentistry, Department of Orthodontics, Aarhus, Denmark.
J A
JA
Pretorius
B
B
Melsen
J C
JC
Nel
P J
PJ
Germishuys
D020341:Absorbable Implants; D016301:Alveolar Bone Loss / Q000503:physiopathology / Q000601:surgery*; D000818:Animals; D001672:Biocompatible Materials / Q000737:chemistry; D001862:Bone Resorption / Q000503:physiopathology; D018786:Bone Substitutes / Q000627:therapeutic use; D016025:Bone Transplantation; D002119:Calcium Carbonate / Q000627:therapeutic use; D020099:Coated Materials, Biocompatible / Q000737:chemistry; D015921:Dental Implants; D017886:Durapatite / Q000737:chemistry; D016557:Guided Tissue Regeneration, Periodontal / Q000295:instrumentation / Q000379:methods; D007575:Jaw, Edentulous / Q000503:physiopathology / Q000601:surgery; D008336:Mandibular Diseases / Q000503:physiopathology / Q000601:surgery*; D008567:Membranes, Artificial; D010012:Osteogenesis / Q000502:physiology; D010215:Papio; D011098:Polyglactin 910 / Q000737:chemistry; D011138:Polytetrafluoroethylene / Q000737:chemistry; D013997:Time Factors; D014025:Titanium / Q000737:chemistry; D014945:Wound Healing / Q000502:physiology
D001672:Biocompatible Materials; D018786:Bone Substitutes; D020099:Coated Materials, Biocompatible; D015921:Dental Implants; D008567:Membranes, Artificial; C094810:Resolut; C434403:calcium carbonate Biocoral; D011098:Polyglactin 910; D011138:Polytetrafluoroethylene; D017886:Durapatite; D014025:Titanium; D002119:Calcium Carbonate