120 Theories and techniques of oral implantology

The results when the opening was placed too high coronally are different (Fig. 4-78). The osseous bridge that began to form underwent an inflammatory breakdown analogous to a periodontal abscess. Under higher power magnification, the inflammatory reaction is clearly seen (Fig. 4-79). From these results, one may conclude that osseous bridges grow through openings in the roots of the tooth replica polymer implant. These openings must not be placed too high coronally but should be placed in the lower third of the implant's root if the osseous bridge is to remain healthy.

The fate of the tissues directly adjacent to the implant material was very promising in some cases. There was good periodontal tissue adaptation composed of regular, well-formed connective tissue.

Fig. 4-80 demonstrates that the connective tissues of the "periodontal" membrane extended into the implant material. Under progressively higher snag-

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nification these clearly appear to be extensions of the periodontal ligament (Fig. 4-81) .

In summary, Hodosh and his associates found osteoblastic activity in the alveolar bone directly adjacent to the pseudoperiodontal membrane around the plastic implant. The fibers of this membrane tended to run in a more vertical direction than with a normal tooth. However, at times these fibers were seen to insert directly into the plastic material. In implants with holes near their apices, the implants were extremely solid within their sockets after 6 to 12 months. They could he removed only by vertical incisions and sectioning of one end of the horizontal bony bridge. Varying, but minimal, degrees of inflammation of the gingival tissue occurred around the plastic implants.

Buhite on Linkow's blade implant

The first histologic report on a blade implant came from Robert Buhite, D.D.S., of Rochester, New

Fig. 4-79. The inflammation and breakdown are more clearly seen under higher magnification. (Courtesy M. Hodosh.)

Fig. 4-80. Even under low power extensions of the connective tissue into the implant are evident. (Courtesy M. I Iodosh. )