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Background:
The socket-shield technique, introduced by Hürzeler in 2010, is characterized by a remaining tooth part being in direct contact to the dental implant. Histologic evaluations in animal studies have given information about this implant-to-tooth interface and showed that bone tissue and cementum can develop in this area, but no research in humans has been published until today. As the behavior of the tooth substance over time is unknown, a long-term human histology might provide informative data.
Aim/Hypothesis:
The aim of this investigation was to histologically analyze the interface between a dental implant, which was found to have been placed into remaining tooth substance, and the dental root. It should be stated which kind of tissue forms in the area between implant and tooth substance and how the contact between the tissues is characterized. If present, signs of inflammation or osteoclastic activity should be identified.
Material and Methods:
A patient with an esthetically and functionally compromised situation was referred for implant placement in the upper jaw. In 2005, more than eight years before, an implant was inserted to replace tooth #12. In a CBCT scan in 2013, a remaining root associated with severe marginal bone loss was diagnosed on the palatal side of this implant. As the implant had a bad prognosis and was not critical for the planned full-arch rehabilitation, it was removed with a trephine bur, maintaining the interface between implant and root. The acquired specimen was evaluated by micro-CT and then prepared by the cutting-grinding technique according to Donath and Breuer (1982) for the light microscopic evaluation. The sections were stained with Sanderson’s RBS stain.
Results:
On both the lingual and buccal aspect, the implant was firmly osseointegrated in bone. Lingually a piece of a tooth root was present. Newly formed bone was interposed between the implant surface and the apical part of a tooth root. Both the interface between bone and cementum as well as the interface between bone and dentin showed an intimate contact between the tissues without any connective tissue interposed. No inflammatory reaction or the presence of osteoclastic activity could be observed.
Conclusions and clinical implications:
In the socket-shield technique, the coronal part of a dental root is kept in place in order to preserve the surrounding hard and soft tissues by maintaining the buccal bone which is present before tooth removal. Questions have arisen if the remaining tooth substance might lead to biological complications like inflammation of the surrounding tissues or if it might be resorbed in long-term view. In the present histologic analysis of a clinical case, the apical part of a tooth has been in place next to an implant for more than eight years, and no inflammatory or osteoclastic signs were found in the histological analysis. These findings might be transferred to the behavior of the tooth substance being used in the socket-shield technique, although they are localized in a more apical level. From the observations in this investigation we can conclude that the remaining piece of dentine does not inevitably have to be subject to ankylosis and resorption.
Background:
The socket-shield technique, introduced by Hürzeler in 2010, is characterized by a remaining tooth part being in direct contact to the dental implant. Histologic evaluations in animal studies have given information about this implant-to-tooth interface and showed that bone tissue and cementum can develop in this area, but no research in humans has been published until today. As the behavior of the tooth substance over time is unknown, a long-term human histology might provide informative data.
Aim/Hypothesis:
The aim of this investigation was to histologically analyze the interface between a dental implant, which was found to have been placed into remaining tooth substance, and the dental root. It should be stated which kind of tissue forms in the area between implant and tooth substance and how the contact between the tissues is characterized. If present, signs of inflammation or osteoclastic activity should be identified.
Material and Methods:
A patient with an esthetically and functionally compromised situation was referred for implant placement in the upper jaw. In 2005, more than eight years before, an implant was inserted to replace tooth #12. In a CBCT scan in 2013, a remaining root associated with severe marginal bone loss was diagnosed on the palatal side of this implant. As the implant had a bad prognosis and was not critical for the planned full-arch rehabilitation, it was removed with a trephine bur, maintaining the interface between implant and root. The acquired specimen was evaluated by micro-CT and then prepared by the cutting-grinding technique according to Donath and Breuer (1982) for the light microscopic evaluation. The sections were stained with Sanderson’s RBS stain.
Results:
On both the lingual and buccal aspect, the implant was firmly osseointegrated in bone. Lingually a piece of a tooth root was present. Newly formed bone was interposed between the implant surface and the apical part of a tooth root. Both the interface between bone and cementum as well as the interface between bone and dentin showed an intimate contact between the tissues without any connective tissue interposed. No inflammatory reaction or the presence of osteoclastic activity could be observed.
Conclusions and clinical implications:
In the socket-shield technique, the coronal part of a dental root is kept in place in order to preserve the surrounding hard and soft tissues by maintaining the buccal bone which is present before tooth removal. Questions have arisen if the remaining tooth substance might lead to biological complications like inflammation of the surrounding tissues or if it might be resorbed in long-term view. In the present histologic analysis of a clinical case, the apical part of a tooth has been in place next to an implant for more than eight years, and no inflammatory or osteoclastic signs were found in the histological analysis. These findings might be transferred to the behavior of the tooth substance being used in the socket-shield technique, although they are localized in a more apical level. From the observations in this investigation we can conclude that the remaining piece of dentine does not inevitably have to be subject to ankylosis and resorption.
Background:
The socket-shield technique, introduced by Hürzeler in 2010, is characterized by a remaining tooth part being in direct contact to the dental implant. Histologic evaluations in animal studies have given information about this implant-to-tooth interface and showed that bone tissue and cementum can develop in this area, but no research in humans has been published until today. As the behavior of the tooth substance over time is unknown, a long-term human histology might provide informative data.
Aim/Hypothesis:
The aim of this investigation was to histologically analyze the interface between a dental implant, which was found to have been placed into remaining tooth substance, and the dental root. It should be stated which kind of tissue forms in the area between implant and tooth substance and how the contact between the tissues is characterized. If present, signs of inflammation or osteoclastic activity should be identified.
Material and Methods:
A patient with an esthetically and functionally compromised situation was referred for implant placement in the upper jaw. In 2005, more than eight years before, an implant was inserted to replace tooth #12. In a CBCT scan in 2013, a remaining root associated with severe marginal bone loss was diagnosed on the palatal side of this implant. As the implant had a bad prognosis and was not critical for the planned full-arch rehabilitation, it was removed with a trephine bur, maintaining the interface between implant and root. The acquired specimen was evaluated by micro-CT and then prepared by the cutting-grinding technique according to Donath and Breuer (1982) for the light microscopic evaluation. The sections were stained with Sanderson’s RBS stain.
Results:
On both the lingual and buccal aspect, the implant was firmly osseointegrated in bone. Lingually a piece of a tooth root was present. Newly formed bone was interposed between the implant surface and the apical part of a tooth root. Both the interface between bone and cementum as well as the interface between bone and dentin showed an intimate contact between the tissues without any connective tissue interposed. No inflammatory reaction or the presence of osteoclastic activity could be observed.
Conclusions and clinical implications:
In the socket-shield technique, the coronal part of a dental root is kept in place in order to preserve the surrounding hard and soft tissues by maintaining the buccal bone which is present before tooth removal. Questions have arisen if the remaining tooth substance might lead to biological complications like inflammation of the surrounding tissues or if it might be resorbed in long-term view. In the present histologic analysis of a clinical case, the apical part of a tooth has been in place next to an implant for more than eight years, and no inflammatory or osteoclastic signs were found in the histological analysis. These findings might be transferred to the behavior of the tooth substance being used in the socket-shield technique, although they are localized in a more apical level. From the observations in this investigation we can conclude that the remaining piece of dentine does not inevitably have to be subject to ankylosis and resorption.
Background:
The socket-shield technique, introduced by Hürzeler in 2010, is characterized by a remaining tooth part being in direct contact to the dental implant. Histologic evaluations in animal studies have given information about this implant-to-tooth interface and showed that bone tissue and cementum can develop in this area, but no research in humans has been published until today. As the behavior of the tooth substance over time is unknown, a long-term human histology might provide informative data.
Aim/Hypothesis:
The aim of this investigation was to histologically analyze the interface between a dental implant, which was found to have been placed into remaining tooth substance, and the dental root. It should be stated which kind of tissue forms in the area between implant and tooth substance and how the contact between the tissues is characterized. If present, signs of inflammation or osteoclastic activity should be identified.
Material and Methods:
A patient with an esthetically and functionally compromised situation was referred for implant placement in the upper jaw. In 2005, more than eight years before, an implant was inserted to replace tooth #12. In a CBCT scan in 2013, a remaining root associated with severe marginal bone loss was diagnosed on the palatal side of this implant. As the implant had a bad prognosis and was not critical for the planned full-arch rehabilitation, it was removed with a trephine bur, maintaining the interface between implant and root. The acquired specimen was evaluated by micro-CT and then prepared by the cutting-grinding technique according to Donath and Breuer (1982) for the light microscopic evaluation. The sections were stained with Sanderson’s RBS stain.
Results:
On both the lingual and buccal aspect, the implant was firmly osseointegrated in bone. Lingually a piece of a tooth root was present. Newly formed bone was interposed between the implant surface and the apical part of a tooth root. Both the interface between bone and cementum as well as the interface between bone and dentin showed an intimate contact between the tissues without any connective tissue interposed. No inflammatory reaction or the presence of osteoclastic activity could be observed.
Conclusions and clinical implications:
In the socket-shield technique, the coronal part of a dental root is kept in place in order to preserve the surrounding hard and soft tissues by maintaining the buccal bone which is present before tooth removal. Questions have arisen if the remaining tooth substance might lead to biological complications like inflammation of the surrounding tissues or if it might be resorbed in long-term view. In the present histologic analysis of a clinical case, the apical part of a tooth has been in place next to an implant for more than eight years, and no inflammatory or osteoclastic signs were found in the histological analysis. These findings might be transferred to the behavior of the tooth substance being used in the socket-shield technique, although they are localized in a more apical level. From the observations in this investigation we can conclude that the remaining piece of dentine does not inevitably have to be subject to ankylosis and resorption.