Light microscopic and scanning electron microscopic analyses of dental implants retrieved from humans.

This paper reports analyses obtained from 51 implant cases retrieved from humans and submitted to the AAIDRF-MCG Implant Retrieval Center. The undecalcified samples were embedded in PMMA and examined with scanning electron microscopy and with routine light or Nomarski microscopy. Cases included individual implants as well as 2 mandibles obtained at autopsy. Retrieved implants were sometimes shown to be encapsulated with connective tissue (CT), whereas other implants were apposed by bone, with only minimal CT association. In the latter cases, the implants were apposed by substantial amounts of viable bone. Nomarski microscopy disclosed the orientation and close apposition of the collagen bundles comprising the interfacial bone. In these cases where close bone apposition was observed to the implants, implant fracture was often the cause of failure. Periodontal lesions were reported around some implants showing a marked degree of inflammatory cell infiltrate (ICI). This study underscores the need for evaluation of failed human dental implants. Failure of implants placed longer than 10 years ago (perhaps loaded immediately) may be due to loss of bone support, CT encapsulation, and ICI (i.e., biological failure). Failure of more recently placed implants could also be due to this scenario, but failure was more often ascribed to biomaterial failure.