Materials and methods : Histological characteristics of advanced peri-implantitis bone defects in humans [2]
Cone beam computed tomographic (CBCT) scans were obtained from each patient for the surgical planning of implant removal. Linear measurements of the defect length (DL) at affected implants were made by drawing a vertical line, following the long axis of the implant, from the implant shoulder (IS) to the bottom of the defect (BD) at buccal and oral aspects in the CBCT data sets (Implant viewer, version 1.84, USA). Radiological evaluations were performed by one experienced and calibrated examiner (M.G.).
Implant removal in all patients was performed by the same clinician (M.B.) following a standardized surgical procedure. Patients were prescribed 500 mg of oral amoxicillin, 3 times a day during 1 week, starting 1 day before surgery. Patients were locally anesthetized (2% lidocaine, 1:100,000 epinephrine). The prostheses of the implants were removed. Surgical incision was performed, and full-thickness mucoperiosteal lingual and buccal flaps were raised; bone-implant biopsies were obtained using a trephine bur under copious irrigation with sterile saline. The implants were removed with the minimal required trephine diameter and without compromising the soft-tissue component for ethical reasons. Specimens were immersed immediately in 10% neutral buffered formalin. Following the removal of granulation tissue from the defect area, mucoperiosteal buccal and lingual flaps were repositioned and fixed with single sutures.
Specimens were dehydrated in ascending series of alcohol and embedded in light-cured resin (Technovit 7200, VLC+BPO, Heraeus, Kulzer Co., Wehrheim Germany). Undecalcified thin ground sections were prepared along the longitudinal axis (bucco-lingual direction) with a high precision diamond-coated band saw and precision grinding equipment (Exakt, Apparatebau, Norderstedt, Germany) [18]. Histological sections were stained with Levai-Laczko dye and scanned with an Olympus BX61VS microscope using a digital virtual light microscopy system (dotSlide 2.4; Olympus, Tokyo, Japan) at a resolution of 0.321 μm/pixel.
Histomorphometrical analysis and microscopic observations were performed by one calibrated examiner (M.G.). Digitalized histological sections (bucco-lingual direction) were analyzed using a morphometric software (Definiens Developer XD 2.0, Definiens AG, Munich Germany). The following landmarks were identified in the stained sections (buccal aspect) (Fig. 1): implant shoulder (IS), level of the alveolar bone crest (BC), bottom of the defect (BD), and the most apical extension of the residual bone tissue (A). Linear measurements were performed by drawing a vertical line following the long axis of the implant: defect length (DL), as measured from IS to BD (mm), residual bone (RB) as measured from BC to A, residual BIC (i.e., the length proportion of the implant surface that was in direct contact with mineralized tissue) as measured as a percentage of the distance from BD to A. The density of the RB was measured as a percentage by dividing the bone area (B.Ar) by the total area of tissues (T.Ar) surrounding the implant.
Serial posts:
- Abstract : Histological characteristics of advanced peri-implantitis bone defects in humans
- Background : Histological characteristics of advanced peri-implantitis bone defects in humans
- Materials and methods : Histological characteristics of advanced peri-implantitis bone defects in humans [1]
- Materials and methods : Histological characteristics of advanced peri-implantitis bone defects in humans [2]
- Materials and methods : Histological characteristics of advanced peri-implantitis bone defects in humans [3]
- Results : Histological characteristics of advanced peri-implantitis bone defects in humans
- Discussion : Histological characteristics of advanced peri-implantitis bone defects in humans [1]
- Discussion : Histological characteristics of advanced peri-implantitis bone defects in humans [2]
- Conclusions : Histological characteristics of advanced peri-implantitis bone defects in humans
- Availability of data and materials : Histological characteristics of advanced peri-implantitis bone defects in humans
- Abbreviations : Histological characteristics of advanced peri-implantitis bone defects in humans
- References : Histological characteristics of advanced peri-implantitis bone defects in humans [1]
- References : Histological characteristics of advanced peri-implantitis bone defects in humans [2]
- References : Histological characteristics of advanced peri-implantitis bone defects in humans [3]
- References : Histological characteristics of advanced peri-implantitis bone defects in humans [4]
- Acknowledgements : Histological characteristics of advanced peri-implantitis bone defects in humans
- Funding : Histological characteristics of advanced peri-implantitis bone defects in humans
- Author information : Histological characteristics of advanced peri-implantitis bone defects in humans [1]
- Author information : Histological characteristics of advanced peri-implantitis bone defects in humans [2]
- Ethics declarations : Histological characteristics of advanced peri-implantitis bone defects in humans
- Additional information : Histological characteristics of advanced peri-implantitis bone defects in humans
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- About this article : Histological characteristics of advanced peri-implantitis bone defects in humans
- Table 1 Patient and implant site characteristics : Histological characteristics of advanced peri-implantitis bone defects in humans
- Table 2 Results from histomorphometric measurements exhibiting DL, RB, bone density (%), residual bone-to-implant contact (%) values : Histological characteristics of advanced peri-implantitis bone defects in humans
- Table 3 Mean osteocyte (OD) and empty lacunae density (ELD) at peri-implant residual bone : Histological characteristics of advanced peri-implantitis bone defects in humans
- Fig. 1. Histological section illustrating the landmarks to determine the conducted histomorphometrical length measurements: DL, RB, and BIC at buccal RB. The red square frames the intra-thread area (ROI) for OD and ELD analysis : Histological characteristics of advanced peri-implant
- Fig. 2. Histological view (buccal aspect) displaying mean BIC (%) and mean bone density (%) at corresponding regions (500 μm zones) from BD to A. Blue lines along the implant perimeter display BIC presence and yellow lines display BIC absence : Histological characteristics of advanced peri-implant
- Fig. 3. Histological magnifications of specimens exposing a significant areas of lamellar bone in-between and parallel to the surface of older trabeculae (accentuated by green overlay), b osteoclastic activity, and c active bone formation at intrabony marginal regions : Histological characteristics of advanced peri-implant