The International Journal of Oral & Maxillofacial Implants, 01/1987

The editorial that appears in this issue of the International Journal of Oral and Maxillofacial Implants was written by Dr. Daniel M. Laskin, Editor of the Journal of Oral and Maxillofacial Surgery and also a Section Editor for JOMI. It is reprinted here at our invitation and with Dr. Laskin's permission because it is pertinent to the implant field today and appropriate for the consumption of our readers. We are indebted to Dr. Laskin for his astute observations and clarity of thought.

The load distributing characteristics of two implant designs, the Brånemark and Core-Vent systems, were studied under both vertical and inclined loading using photoelastic models. Applied loads were transferred to the supporting structure more equitably with the Brånemark design than with the Core-Vent design.

The interface mechanical characteristics and histology of CP titanium and hydroxylapatite (HA)-coated titanium were investigated. The HA-coated system developed five to eight times the mean interface strength of the uncoated, bead-blasted CP titanium system. Histologic evaluations in all cases revealed mineralization of interface bone directly onto the HA coated implant surface, becoming part of the implant composite system. The uncoated implants had a thin fibrous interpositional layer present in most areas, with projections of bone in apposition to the implant surface in a limited number of locations. The results of this study indicate that the HA-coated titanium system may be attractive for use in endosseous dental implant applications.

Scanning electron microscopy and spectral surface analysis were used to compare and contrast the microstructure of two osseointegrated implant systems. Results suggested that one system was superior to the other in terms of surface quality, definition, and reproducibility.

The polyacetyl homopolymer polyoxymethylene (Delrin) has been used successfully in orthopedic joint replacements. The efficacy of using Delrin as mandibular condylar replacement in growing children and to determine the effect on fossa remodeling of such replacement, condyles were removed unilaterally in six papio anubis baboons 11/2 to 2 yr of age. The condyles were then replaced with a total prosthetic Delrin condyle attached to a titanium mesh. Specimens retrieved on sacrifice at two, four, and six mo indicated not only complete acceptance of the Delrin but also formation of bone between the middle cranial fossa and the roof of the glenoid fossa. Total bony integration of the Delrin occurs leading to the formation of a new condyle growth center provided that effective orthopedic forces are maintained to distract the condyle slightly from the glenoid fossa base. This work could project the possibility of a totally new concept of total joint replacement in children having various types of deformities such as hemifacial microsomia.

Since 1979 osseointegrated implants with percutaneous abutments have been used for retention of craniofacial prostheses. This article focuses on the skin condition around the titanium implants that are used for anchoring auricular prostheses. A total of 136 implants (from 32 patients) were followed for 3 to 66 months. These figures represent 708 visits, a total observation time of 3,468 months of clinical performance.