108 Theories and techniques of oral implantology

noted close to the periphery of the strip [Fig. 4-50]. In other areas the connective tissue appears more cellular and contains numerous islands of bone [Fig. 4-51]. The stroma surrounding these islands shows abundant production of osteoid tissue. Numerous osteocytes are seen within the bone fragments [Fig. 4-52], and evidence of lamellar deposition and ostcoblastic rimming are apparent. Small marrow spaces contain fibrous tissue and small vessels.

Case 3. A male patient, age 60, received a traumatic injury to his left mandible during a car acci-

dent. One of his vent-plants, which helped support a full arch fixed prosthesis, was knocked loose from the surrounding bone with a good portion of bone attached to it. However, the one directly nearest to the implant was still attached. The bridge and the implant were removed (Fig. 4-53). Since the patient did not appear for at least 6 weeks after the accident, the outer aspect of the bone attached to and surrounding the implant acted as a sequestrum, and therefore the lacunae in this area were devoid of osteocytes. The innermost surface of the bone contained osteocytes in the lacunae, since these cells were nearest

Fig. 4-53. A, The full-arch prosthesis was removed, exposing the vent-plants and the one remaining left cuspid tooth. The arrow points to the loosened implant. B, Bone was firmly attached to the vent-plant.

Fig. 4-54. Beyond the fibrous tissue lies bone, which follows the shape of the implant site (X).