Guarnieri Renzo, Testarelli Luca, DeVilliers Patricia
Quintessence Int. 2020;51(5):398-404. doi: 10.3290/j.qi.a44369.
To describe and illustrate the histologic characteristics of luting cement-induced peri-implantitis in the posterior maxilla of a 56-year-old man.
A dental implant inserted 6 years previously in the maxillary left first premolar region revealed pus and swelling. A periapical radiograph showed severe bone loss around the dental implant, and the presence of surrounding residual particles of luting cement. The implant was removed with its adjacent tissues. The harvested implant was fixed in formaldehyde solution (formalin). A 4-mm fragment of soft tissue and a 6-mm fragment of bone were cut from the implant specimen and submitted for routine processing of hematoxylin-eosin (h&e) slides for histologic analysis. The implant specimen was processed and embedded in glycol methacrylate resin and ground to a thickness of 50 µm for histologic examination.
The microscopic examination of the h&e slides showed connective tissue with an inflammatory infiltrate composed of histiocytes, lymphocytes, and plasma cells. There was a fragment of viable bone integrated with the bone graft material. The bone showed evidence of active resorption by osteoclasts in Howship lacunae. The implant sections showed trabecular bone with lamellar structure in the apical portion. Foreign body, compatible with luting cement, was present in the coronal portion, adjacent to the threads of the implant, as well as osteoclasts in Howship lacunae.
This report, documenting a case of peri-implantitis associated with excess cement extrusion, revealed that that the bone loss was associated with an inflammatory infiltrate. Additional studies focusing on the histopathologic characteristics of peri-implantitis could help to increase the knowledge of peri-implant disease to shed light on prevention and treatment.
描述并阐明一名56岁男性上颌后牙区粘结水门汀引发种植体周围炎的组织学特征。
6年前植入上颌左侧第一前磨牙区的一枚牙种植体出现了脓液和肿胀。根尖片显示种植体周围严重骨吸收，且存在周围残留的粘结水门汀颗粒。将种植体与其相邻组织一并取出。取出的种植体固定于甲醛溶液（福尔马林）中。从种植体标本上切取4毫米的软组织片段和6毫米的骨组织片段，提交进行苏木精-伊红（H&E）染色切片的常规处理，以进行组织学分析。种植体标本经过处理后包埋于甲基丙烯酸乙二醇酯树脂中，磨至50微米厚进行组织学检查。
H&E染色切片的显微镜检查显示结缔组织中有由组织细胞、淋巴细胞和浆细胞组成的炎性浸润。有一片存活骨与骨移植材料整合在一起。骨组织显示出破骨细胞在哈弗斯陷窝中进行活跃吸收的证据。种植体切片在根尖部分显示出具有板层结构的小梁骨。在种植体螺纹相邻的冠部存在与粘结水门汀相符的异物，以及哈弗斯陷窝中的破骨细胞。
本报告记录了一例与过多水门汀挤出相关的种植体周围炎病例，揭示了骨吸收与炎性浸润有关。专注于种植体周围炎组织病理学特征的更多研究可能有助于增加对种植体周围疾病的认识，从而为预防和治疗提供线索。
