The International Journal of Oral & Maxillofacial Implants, 03/1987

The effect of treating the surface of tricalcium phosphate (TCP) ceramic coated titanium implants with microfibrillar collagen gel was compared with noncollagen-coated control TCP implants. The tissue-implant interface was examined histologically and morphometrically for enhancement of osseointegration at periodic healing intervals in canine jaws. The collagen treatment resulted in consistent and accelerated bone healing into the implants. The collagen probably acted as a scaffold for outgrowth of preosteoblasts from the bone surface to the implant. In addition, a smaller inflammatory healing response was evoked by the collagen-coated implants, which indicates a better biologic acceptance of these implants.

A technique that employs new computer-assisted tomography (CT) computer software generates oblique and panoramic CT images of the mandible. These images facilitate preoperative planning and permit precise positioning of endosseous implants.

A computed tomography technique for frontal, lateral, oblique, and panoramic images of the maxilla is described. The images aid in preparing for the surgical placement of endosseous implants.

A simplified porous, hollow, cylindrical implant design and a rabbit animal model were developed to study bone ingrowth into porous implants using plastic-embedded groundsection microscopic techniques. It was found that bone ingrowth was independent of pore size in the 0.6 to 1.0 mm pore-size range: however, ingrowth of bone increased significantly by 8 weeks after implantation.

Patients who present with severe maxillary bone loss secondary to trauma, congenital defect, or resorption secondary to prosthesis function provide a unique diagnostic and difficult treatment challenge. This article describes a prosthetic-surgical treatment approach utilizing threaded titanium cylindrical endosteal (Brånemark) implants in combination with iliac bone grafting in nine such patients. Five patients received implant and bone graft placement at the same surgical setting and four patients received the implant 6 to 18 months following bone graft placement. Treatment sequence, surgical technique, indications, and follow-up results are illustrated by abbreviated case reports of four patients.

Modifications for inserting the mandibular staple implant, which have greatly streamlined the operative procedure, are presented. The first procedure involves a method of mucosal grafting around the transosseous pins in situations where attached gingivae is needed. A second procedure describes a method of placing the mandibular staple implant intraorally by degloving the symphysis of the mandible. Staples placed intraorally and in place for two years with extremely low morbidity are discussed.

The fabrication and use of fixed provisional restorations for partially edentulous patients undergoing treatment to provide osseointegrated fixture support for prostheses is described. Additional benefits include the use of the provisional prosthesis as a diagnostic aid, healing adjunct, and interim restoration during maintenance periods.