Abstract
Symmetric and well-organized connective tissues around the longitudinal implant axis were hypothesized to decrease early bone resorption by reducing inflammatory cell infiltration. Previous studies that referred to the connective tissue around implant and abutments were based on two-dimensional investigations; however, only advanced three-dimensional characterizations could evidence the organization of connective tissue microarchitecture in the attempt of finding new strategies to reduce inflammatory cell infiltration. We retrieved three implants with a cone morse implant–abutment connection from patients; they were investigated by high-resolution X-ray phase-contrast microtomography, cross-linking the obtained information with histologic results. We observed transverse and longitudinal orientated collagen bundles intertwining with each other. In the longitudinal planes, it was observed that the closer the fiber bundles were to the implant, the more symmetric and regular their course was. The transverse bundles of collagen fibers were observed as semicircular, intersecting in the lamina propria of the mucosa and ending in the oral epithelium. No collagen fibers were found radial to the implant surface. This intertwining three-dimensional pattern seems to favor the stabilization of the soft tissues around the implants, preventing inflammatory cell apical migration and, consequently, preventing bone resorption and implant failure. This fact, according to the authors’ best knowledge, has never been reported in the literature and might be due to the physical forces acting on fibroblasts and on the collagen produced by the fibroblasts themselves, in areas close to the implant and to the symmetric geometry of the implant itself.
Highlights
The collagen bundles that were transversely aligned to the light propagation direction, i.e., that were parallel to the section plane, appeared bright because of the variation of the existing light refraction, while the collagen fibers aligned along the light propagation axis, i.e., perpendicular to the plane of the section, appeared in a different color because refraction did not occur
Synchrotron radiation (SR) microCT is usually based on conventional settings, i.e., on attenuation properties of tissues inside the sample, that are related to the β value, i.e., to the complex part of the index of refraction n = 1 − δ + iβ
The histological analysis of the peri-implant soft tissues showed that the biological width (BW) was composed of sulcular epithelium (SE), which continued with junctional epithelium (JE) and was in close contact with the implant surface
Summary
Well-organized connective tissues around the implant were hypothesized to decrease early bone resorption by reducing inflammatory cell infiltration. Only advanced three-dimensional (3D) characterizations could enhance the knowledge of connective tissue architecture in the attempt of finding new strategies to reduce inflammatory cell infiltration with the consequent decrease of early bone resorption. In this framework, X-ray phase-contrast imaging may represent a powerful method to study the 3D organization of connective tissue around the abutments, as it allowed to achieve reliable 3D imaging, with increased contrast, of several organs/tissues [18]. A secondary aim was to evaluate how physical forces drive collagen organization, supporting the stabilization of soft tissues and, decreasing the possibility of bone resorption and implant failure
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