Daher Shadi, Leary Joseph, Ewers Rolf, Coelho Paulo G, Bonfante Estevam Augusto
Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA.
Periodontist, Implant Dentistry Centre, Boston, MA.
J Long Term Eff Med Implants. 2019;29(2):135-140. doi: 10.1615/JLongTermEffMedImplants.2019031828.
We describe the retrieval of a dental implant device that had been successfully osseointegrated for more than 4 years. After obtaining an informed patient consent, the device was retrieved for retreatment purposes from its position in a β-tricalcium phosphate (β-TCP) grafted sinus floor. The sinus floor augmentation, using β-TCP, had been performed in conjunction with the original implant placement, which in turn enabled the histological evaluation of specific regions of interest that were comprised of either grafted or native bone. Radiographs documented the rehabilitated area before and after grafting. The osteogenic events that occurred during the 4-yr-period depict the interplay of implant, synthetic graft material, and native bone in a dynamic process of osteogenesis, ongoing bone maturation, and remodeling that led to the development of haversian-like bone morphology. Two distinct areas were observed histologically, wherein osteointegration occurred uneventfully in both native bone and areas of grafted bone. Of particular interest was the presence of multiple remodeling sites of lamellar bone that could be seen between the plateaus-healing chambers-in which bone eventually evolved into a haversian cortical-like configuration.
我们描述了一例成功骨整合超过4年的牙种植体装置的取出过程。在获得患者知情同意后，为了再治疗目的，将该装置从其位于β-磷酸三钙（β-TCP）移植的上颌窦底的位置取出。使用β-TCP进行上颌窦底提升术是与最初的种植体植入同时进行的，这反过来又使得能够对由移植骨或天然骨组成的特定感兴趣区域进行组织学评估。X线片记录了移植前后的修复区域。在4年期间发生的成骨事件描绘了种植体、合成移植材料和天然骨在成骨、持续骨成熟和重塑的动态过程中的相互作用，这导致了哈弗斯样骨形态的发展。组织学观察到两个不同的区域，其中天然骨和移植骨区域均顺利发生骨整合。特别值得关注的是，在平台愈合腔之间可以看到多个板层骨重塑部位，最终骨演变成哈弗斯皮质样结构。
