At one month after two implants of single crystal alminum oxide were implanted in the mandible of adult monkeys, a superstructure was cemented connecting the two implants without connection with the natural teeth. Adaptation of the surrounding tissue of the implants under occlusal function were observed for 12 months from one month after cementing, and clinical, roentogenographic, light microscopic investigations were made. The results were as follows : 1. Clinically, the gingiva surrounding the implants healed favorably and showed findings similar to those of the adjacent natural teeth one month after cementing of the superprosthesis and thereafter. The implants were immobile by finger. The depth of pockets of the surrounding gingiva was within the range of 0.5-1.0mm for both S and T types 12 months after cementing. No deep pockets were formed and no marked difference in depth was seen from that of the gingival sulcus of the adjacent natural teeth. 2. Roentogenographically, no marked changes were seen between one month after and immediately after insertion of the superprosthesis. At three months and thereafter, however, lamina dura indicative of newly generated bone formation was observed around the implants for both S and T types. Lamina dura widened with time at 6 and 12 months. In one of the three monkeys of 3-month cases, a thin radiolucent area was seen between the implant and the bone. 3. In the gingival epithelium, down-growth of epithelium bordering the implant reached as far as infrabone in one of T type of 1-month cases, two each of S and T types of 3-month, one each of S and T types of 6-month, and one of S type of 12-month. In the others, the extent was slight. 4. At the lamina propria of the gingiva, inflammation was slight and the connective fibers were arranged densely surrounding the implants. In the surface facing the implant, however, they were running parallel to the axis. 5. In the cases of one month after insertion, the implant was surrounded by young new bone for both S and T types and bone trabeculae grew dense with time at 3, 6, and 12 months. Haversian canals were formed after 3 months. 6. In one of the three monkeys of 3-month cases, a layer of fibrous connective tissue interposed between the implant and the bone for both S and T types. Its width was within the range of 150-250μm for S type and 50-100μm for T type. In one of the three monkeys of 6-month cases, the screw of S type was in direct contact with the bone in some parts, and in other parts fibrous connective tissue interposed between the screw and the bone. The tissue width was within the range of 100-200μm. Except for these cases and 1-month cases, all the implants were in direct contact with the bone for both S and T types. 7. Scanning electron microscopically, in both 6-month and 12-month cases, epithelial cells and fibroblasts were attached at the post on the surface of the implant for S and T types. Where the implant was in direct contact with the bone, only many amorphous materials of different sizes were observed and cell-like structures were not seen. On the basis of the foregoing, it was confirmed that : (1) the surrounding tissue healed favorably even under functional conditions after insertion of implants of single crystal alminum oxide, (2) abnormal findings such as foreign-body reaction were not seen, (3) histo-compatibility was excellent, and (4) connecting two implants without connecting them with natural teeth enabled them to withstand biting pressure sufficiently, provided that load was not excessive physiologically. For use for longer duration, however, it was thought that oral hygiene and harmonious occlusion were important. For clinical application, it was thought the use of implants with discrestion would bring favorable results.
Read full abstract