Degenerative and regenerative morphological aspects in peri-implantitis.

Ultrastruct Pathol

b Plastic Surgery and Reconstructive Microsurgery Clinic, Clinical Emergency Hospital Bucharest, Bucharest , Romania.

Published: March 2017

AI Article Synopsis

  • - The study analyzed the tissues around two failed dental implants using different microscopy techniques, including scanning electron microscopy (SEM) and light microscopy (LM), revealing a mix of healthy and unhealthy cellular responses.
  • - In the first case, there was evidence of infection and a lack of mineralization around the implant, with various inflammatory cells and microorganisms identified, indicating a degenerative process.
  • - The second case showed promising regenerative activity, with mesenchymal stem cells differentiating into epithelial cells and forming new blood vessels, leading to bone formation around the implant despite previous degeneration, suggesting a balance of repair and failure mechanisms.

Article Abstract

The purpose of this study was to describe the tissues surrounding two early failed dental implants morphologically and ultrastructurally. In the first case, the implant's surface was analyzed by scanning electron microscopy (SEM) using an environmental scanning electron microscope and the surrounding tissues were analyzed by light microscopy (LM) and transmission electron microscopy. In the second case we used only LM. By SEM analysis, very thin connective tissue was seen at the implant's apex; in the middle part, highly vascularized connective tissue and poorly mineralized areas were found, and there were fewer mineralized areas at the implant's base. Histologically and ultrastructurally, we identified a heterogeneous cellular population including fibroblast-like cells and osteoblasts with abundant amorphous extracellular matrix, as well as a number of inflammatory cells, predominantly neutrophils. In a small area around the implant, microorganisms classified as Actinomyces were identified. In this case, degenerative aspects were predominantly caused by infection. In the second case, our observations focused on recruitment of mesenchymal stem cells, their proliferation and differentiation into epithelial cells with keratinocyte phenotype, and formation of de novo capillaries from mesenchymal progenitors of endothelial cells. These regenerative events were accompanied by multiple areas of mineralization, culminating in bone formation around the implant. Correlative microscopic observations are necessary to conduct in future studies, in various clinical conditions and post-operative stages, to better define the cellular events involved in healing and osseointegration; our observations clearly depict significant regenerative aspects despite the degenerative ones.

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Source
http://dx.doi.org/10.3109/01913123.2016.1154632DOI Listing

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