A laboratory study comparing the effect of ridge exposure using tissue punch versus mucoperiosteal flap on the formation of the implant-epithelial junction.
OBJECTIVE
The objective of the present study was to clarify the influence of the incision design at the time of implant placement on the consolidation of the implanto-epithelial junction.


METHODS
Twelve minipigs were chosen for the study. Four weeks after premolar extraction in the maxilla, 4 BEGO Semados RI implants were inserted in each quadrant. Using a split-mouth design, the alveolar crest was exposed by a punch ("flapless surgery") on one side and by a crestal incision ("flap surgery") on the other side. Biopsies were obtained from the peri-implant soft tissue at weeks 1, 2, 4, and 12 postinsertion, respectively, and analyzed for the expression of integrin α(6)β(4) chain β(4) (ITGB4) and laminin 5 γ(2) chain (lamc2), 2 important marker molecules for the formation of the implanto-epithelial junction.


RESULTS
Following exposure of the alveolar crest by the punch technique, a significantly higher expression of ITGB4 was found at the 2- (P = .009), 4- (P = .001), and 12-week (P = .005) follow-up. Furthermore, the expression of lamc2 was significantly higher following punch exposure after 1 (P = .033), 2 (P = .041), 3 (P = .004), and 12 weeks (P = .002) of transmucosal implant healing.


CONCLUSIONS
The data of the present study indicate that flapless placement improved the formation of a sufficient implanto-epithelial junction.
Department of Oral and Maxillofacial Surgery/Plastic Surgery, School of Medicine, University of Jena, Germany. cornelia.mueller1@med.uni-jena.de
Cornelia K
CK
Mueller
Michael
M
Thorwarth
Jiang
J
Chen
Stefan
S
Schultze-Mosgau
D000539:Alveolar Process / Q000601:surgery*; D000818:Animals; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D004846:Epithelial Attachment / Q000473:pathology*; D005455:Fluorescent Antibody Technique; D005890:Gingivectomy / Q000379:methods*; D039641:Integrin beta Chains / Q000032:analysis; D007576:Jaw, Edentulous, Partially / Q000473:pathology* / Q000601:surgery; D007797:Laminin / Q000032:analysis; D008437:Maxilla / Q000601:surgery*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013524:Surgical Flaps / Q000473:pathology*; D013552:Swine; D013556:Swine, Miniature
D015921:Dental Implants; D039641:Integrin beta Chains; D007797:Laminin