Immunohistochemistry of soft tissues surrounding late failures of Branemark implants
Immunohistochemistry of soft tissues surrounding late failures of Branemark implants
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DOI：
10.1034/j.1600-0501.1997.080502.x
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发表时间：
1997-10-01
影响因子：
4.3
通讯作者：
Lekholm, U
中科院分区：
文献类型：
--
作者：
Esposito, M;Thomsen, P;Lekholm, U
本研究的目的是表征连续恢复的 Branemark 种植体晚期失败周围软组织的细胞组成。种植体失败的标准是骨整合丧失的迹象（射线照相固定装置周围的射线可透性和活动性）。植入物的临床病史不包括不良症状。取出时，4/8 个种植体出现敲击引起的疼痛，但没有观察到炎症或感染的宏观迹象，对 6 个种植体周围边缘标本和 8 个失败种植体的先前承重种植体表面相关的深层组织标本进行了免疫组织化学分析，而 6 个临床健康粘膜标本和 4 个来自稳定种植体的增生性活检作为对照。免疫组织化学评估显示，失败种植体周围的软组织含有大量巨噬细胞（CD68）、HLA-DR阳性细胞、淋巴细胞和浆细胞，优先向移除的种植体表面聚集。 PMN 是一个罕见的发现。在保留完整植入物/软组织界面的切片中观察到上皮向下生长，在某些情况下封装整个固定装置。健康对照粘膜样本始终含有标记细胞，尽管含量较低，而增生性对照样本显示出强烈的炎症和免疫反应，在整个活检中散布着大量阳性细胞和中性粒细胞。总之，失败的植入物的特点是周围组织的慢性炎症反应，巨噬细胞是主要的标记细胞类型，而稳定的植入物周围的增生组织则以急性炎症过程为特征，这些发现表明持续的感染不太可能是病因因素对于本研究中检查的牙种植体的晚期失败。
The objective of the present investigation was to characterize the cellular composition of the soft tissues surrounding consecutively retrieved late failures of Branemark implants. Criteria for implant failure were signs of loss of osseointegration (radiographic peri-fixtural radiolucency and mobility). The clinical history of the implants did not include adverse symptoms. At the time of retrieval, percussion-induced pain was experienced at 4/8 implants, but no macroscopical signs of inflammation or infection was observed, Immunohistochemistry was applied on 6 marginal peri-implant specimens and on specimens of deeper tissues associated with the previously load-bearing implant surface from 8 failed implants, whereas 6 clinically healthy mucosal specimens and 4 hyperplastic biopsies from stable implants served as controls. The immunohistochemical evaluation showed that the soft tissues surrounding failed implants contained a large number of macrophages (CD68), HLA-DR positive cells, lymphocytes and plasma cells preferentially accumulated towards the removed implant surface. PMNs were a rare finding. Downgrowth of epithelium, in some cases encapsulating the whole fixture, was observed in sections where an intact implant/soft tissue interface was preserved. Healthy control mucosal specimens always contained labelled cells, albeit in a low amount, whereas hyperplastic control samples displayed an intense inflammatory and immunological response with numerous positive cells and PMNs scattered throughout the biopsy, In conclusion, failed implants were characterized by a chronic inflammatory response of the surrounding tissues with macrophages as the predominant labelled cell type, while hyperplastic tissues around stable Implants were distinguished by an acute inflammatory process, These findings suggest that an on-going infection is unlikely to be the etiological factor for the late failures of dental implants examined in this study.