Cementum formation around a titanium implant: a case report

Area of Science:

• Oral biology
• Dental implantology
• Periodontology

Background:

• Animal studies suggest periodontal ligament (PDL) regeneration around titanium implants in contact with retained roots.
• Cementum and PDL formation at the implant-root interface indicate cementum progenitor cells in the PDL.
• Osseointegration occurs on implant surfaces not in contact with the root.

Observation:

• Histological evaluation of a human explant (titanium implant adjacent to a retained root due to peri-implantitis) was performed.
• A continuous layer of cementum with cementocytes was observed on the implant surface at the root interface.
• The space between the implant and root lacked blood vessels and collagen fibers, unlike findings in animal models.

Findings:

• The human specimen showed cementum deposition on the implant surface, but lacked connective tissue fibers.
• Hypercementosis and cementum hypertrophy were present, potentially linked to the inflammatory process and root extrusion.
• The histological findings differ from animal studies, suggesting inflammation may influence tissue response in humans.

Implications:

• The study questions whether cementum and collagen fiber neoformation on implants with root residues occurs similarly in humans as in animal models.
• Inflammation associated with peri-implantitis may significantly alter the regenerative potential observed in experimental animal studies.
• Further human studies are needed to clarify the regenerative capacity of tissues around implants in the presence of root remnants.