Biologic Width Around Titanium Implants. A Histometric Analysis of the Implanto‐Gingival Junction Around Unloaded and Loaded Nonsubmerged Implants in the Canine Mandible

Abstract

The use of endosseous dental implants as transmucosal devices necessitates the successful integration of three different tissues: bone, connective tissue, and epithelium. So far, studies have predominantly focused on hard tissue integration. Much less is known about soft tissues. This study examined the dimensions of the implantogingival junction in relation to clinically healthy unloaded and loaded nonsubmerged implants. In total, 69 titanium plasma-sprayed (TPS) and sandblasted acid-etched (SLA) implants were placed in an alternating fashion in six foxhounds and allowed to heal for 3 months. Two dogs were sacrificed after the initial healing period. The remaining four dogs had crowns fabricated that were allowed to function for up to 12 months. These animals were sacrificed after 3 and 12 months of loading. Histometric analysis of undecalcified histologic sections included the evaluation of the sulcus depth (SD), the dimensions of the junctional epithelium (JE), and the connective tissue contact (CTC). Mean values in the 3 month unloaded group were 0.49 mm for SD, 1.16 mm for JE, and 1.36 mm for CTC. These dimensions were 0.50 mm for SD, 1.44 mm for JE, and 1.01 mm for CTC for the 3 month loaded group. After 12 months of loading, these values were 0.16 mm for SD, 1.88 mm for JE, and 1.05 mm for CTC. The sum of these measurements was similar for the different time points and similar to the same dimensions around teeth. TPS and SLA surfaces had no influence on the evaluated parameters (P > 0.05). The data suggest that a biologic width exists around unloaded and loaded nonsubmerged one-part titanium implants and that this is a physiologically formed and stable dimension as is found around teeth.

X-ray evaluation at 5-6 years of Straumann implants (part 1)

“…Bone loss within the first year of loading was also attributed to the biologic width formation [54], a process previously described. Implant failure was studied on machined implants as early as 1989 [55].…”

“…Low degrees of implant mobility could also be assessed using an electronic device (Periotest , Siemens, Bensheim, Germany). Mobility tests were not considered a valuable predictive method [54,55]. None of these methods were investigated in the current study.…”

Biologic Width Around Dental Implants.

“…Cochran et alevaluated the dimension of the implanto-gingival junction around non submerged loaded and unloaded implants testing two different surfaces (SLA and TPS) at 3 and 12 months after implant placement (Cochran et al 1997). At 3 months, the dimension of the constituents of the biological width in the unloaded group were 0.49mm for the sulcus depth (SD), 1.16 mm for the junctional epithelium (JE), and 1.36 mm for the connective tissue component (CTC).…”

“…As a consequence, increasing attention was given to study peri-implant crestal bone as well as soft tissue reactions. Thus, several authors presented histometric data on two-piece, submerged as well as nonsubmerged implants (Berglundh et al 1991, Abrahamsson et al 1996, 1997.…”

Evaluation of Marginal Bone Level around Platform-Switched Implants

“…The etiologic factors associated with crestal bone loss are the size of the microgap 4 between the implant and the abutment, bacterial colonization of the implant sulcus, 5 biologic width formation, 6 surgical trauma to the bone, 7 periimplantitis, 8,9 occlusal overload, 10,11 and implant-abutment interface design. 12 Peri-implant soft tissue consist of approximately 1 mm of connective tissue, 1 mm of epithelium and 1 mm of sulcus, resulting in 3 mm of biological width.…”