Scanning Electron Microscopic Studies of the Oral Tissue Responses to Dental Implants

Scanning electron microscopy ( SEM) and its associated technologies have proven invaluable in elucidating the interfacial oral tissue responses to dental implants. Since the dental implant must extend from the mandibular or maxillary jaw, through the oral mucosa, and into the oral cavity, these tissue responses include epithelium, connective tissue and bone. The continual occlusal forces acting upon these tissues reinforce the dynamic character of these tissue responses. Immediately upon implantation, a healing phase begins as a response to the implanted biomaterial. Following this immediate response a longer healing phase occurs, beginning approximately 1 week after implantation, resulting in the modeling of bone to the implant as well as the formation of epithelial attachment to the implant. This later, delayed healing continues throughout the lifetime of the implant since these tissues must die and be replaced by similar tissues. Current dental research employing scanning electron microscopy is now documenting these tissue responses. This paper reviews, in detail, SEM observations of these tissue responses

Ultrastructural Investigations of the Bone and Fibrous Connective Tissue Interface with Endosteal Dental Implants

The interface between the tissues of the oral cavity and ceramic and titanium cylindrical endosteal dental implants was investigated with correlated light microscopy, transmission electron microscopy and scanning electron microscopy. This study suggested that mandibular bone can directly interface and form an intimate association with one-stage endosteal dental implants. This potential attachment matrix is composed of a composite of calcified bone, and an osteoid unmineralized matrix in association with an apparent osteogenic connective tissue. Further, results from this study suggested that at a level inferior to the junctional epithelium, and superior to the level of crestal bone, fibrous connective tissue can attach to the dental implant. This non-loadbearing attachment of gingival connective tissue could, by contact inhibition, prevent apical epithelial migration. In association with previously documented epithelial attachment, such apical support and connective tissue attachment appears to suggest that endosteal dental implants can be adequately maintained in the oral cavity

SURGICAL TREATMENT OF CHRONIC OROFACIAL PAIN

SUMMARY There are many conditions in which chronic orofacial pain is a major diagnostic and therapeutic problem. It is generally accepted that surgical treatment for these chronic pain problems should be resorted to only when more conservative treatments have been ineffective. Literature concerning selected orofacial pain problems is reviewed and the indications for surgical management are discussed