The barrier between the keratinized mucosa and the dental implant. An experimental study in the dog

The present study was performed in order to examine the composition of the connective tissue that forms an attachment to a dental implant. 6 beagle dogs were used. All mandibular premolars were extracted. After 3 months of healing, 6 fixtures--3 in each side of the mandible--(Astra Tech Implants, Dental System TiO blast; Astra Tech AB, Mölndal, Sweden) were installed. After another 3 months of healing, abutment (Uni-abutment 45; Astra Tech AB, Mölndal, Sweden) connection was performed and a plaque control program was initiated. The animals were sacrificed and perfused with a fixative through the carotid arteries. Each implant site, including the implant and the soft and hard peri-implant tissues, was dissected, decalcified in EDTA and further processed using a "fracture technique". The specimens were subsequently embedded in EPON, cut with the microtome set at 3 microm and the sections stained in PAS and toluidine blue. From the EPON-embedded blocks, ultra-thin sections were cut and electron micrographs were prepared. The detailed histologic and morphometrical examinations were restricted to a 200 microm wide zone of connective tissue interposed between the apical border of the junctional epithelium and the bone tissue. In the analysis, this zone was further subdivided into 2 different units; (i) one central, 40 microm wide unit (zone A) located immediately next to the implant surface, and (ii) one lateral, 160 microm wide unit (zone B) that was continuous with the central unit. The implant surface apical of the junctional epithelium and coronal of the bone crest appeared to be in direct contact with a connective tissue. Zone A of this connective tissue was characterized by its (i) absence of blood vessels and (ii) abundance of fibroblasts which were interposed between thin collagen fibers. The more lateral zone B contained comparatively fewer fibroblasts, but more collagen fibers and blood vessels. There are reasons to assume that the fibroblast rich barrier tissue next to the titanium surface plays a rôle in the maintenance of a proper seal between the oral environment and the peri-implant bone.