title: Morphogenesis of the peri-implant mucosa: an experimental study in dogs.
abstract: OBJECTIVE
  The objective of the present experiment was to study the morphogenesis of the mucosal attachment to implants made of c.p. titanium.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Periodontology, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden. berglundh@odontologi.gu.se
authors.forename: Tord
authors.initials: T
authors.lastname: Berglundh
authors.forename: Ingemar
authors.initials: I
authors.lastname: Abrahamsson
authors.forename: Maria
authors.initials: M
authors.lastname: Welander
authors.forename: Niklaus P
authors.initials: NP
authors.lastname: Lang
authors.forename: Jan
authors.initials: J
authors.lastname: Lindhe
mesh_terms: D000818:Animals; D001777:Blood Coagulation / Q000502:physiology; D003094:Collagen; D003238:Connective Tissue / Q000254:growth & development / Q000473:pathology; D015921:Dental Implants; D003764:Dental Materials; D004285:Dogs; D004846:Epithelial Attachment / Q000254:growth & development / Q000473:pathology; D004848:Epithelium / Q000254:growth & development / Q000473:pathology; D005347:Fibroblasts / Q000473:pathology / Q000502:physiology; D008334:Mandible / Q000601:surgery; D023421:Models, Animal; D009024:Morphogenesis / Q000502:physiology*; D009504:Neutrophils / Q000473:pathology / Q000502:physiology; D010519:Periodontium / Q000254:growth & development* / Q000473:pathology; D014025:Titanium; D014945:Wound Healing / Q000502:physiology
chemical_list: D015921:Dental Implants; D003764:Dental Materials; D003094:Collagen; D014025:Titanium