Editorial Type:
Article Category: Research Article
 | 
Online Publication Date: 01 Oct 2006

Effects of Periodontal Cell Grafts and Enamel Matrix Proteins on the Implant–Connective Tissue Interface: A Pilot Study in the Minipig

DMD, PhD,
DM, PhD,
BDS, DDS, MS,
PhD, and
DDS
Page Range: 228 – 236
DOI: 10.1563/820.1
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Abstract

We have developed an experimental model to help identify and characterize factors necessary for periodontal connective tissue attachment formation on dental implants. In this pilot study, we report the effect of autogenous periodontal cell grafts, with and without the application of enamel matrix derivative (EMD), on the implant–connective tissue interface. Periodontal ligament (PDL) and gingival connective tissue (GCT) cultures were established from an adult minipig. Implants were placed in osteotomies prepared with exaggerated countersinks that served as recipient sites for autogenous cell grafts in bilateral edentulated posterior mandibular sextants. In addition, 1 side received an application of EMD before placement of the autogenous cell grafts. A bioabsorbable membrane covering the coronal portion of the implants was placed before closure. After 8 weeks, quantitative histomorphometric and qualitative light microscopic analyses revealed that the implants that received gelatin vehicle alone were surrounded by bone, whereas the implants that received GCT cell grafts were mostly surrounded by fibrous connective tissue. In contrast, implants that received PDL cells without the application of EMD demonstrated good bone contact, but strands of epithelium were observed in the implant–connective tissue interface. Implants that received PDL cells and EMD also had good bone contact but without evidence of epithelium. A cementum-like interface was not observed in any of the groups. Results of this pilot study suggest that EMD and the type of cell populations present in the implant wound-healing environment may alter the implant–connective tissue interface.

Copyright: American Academy of Implant Dentistry
<sc>Figure</sc>
1.
Figure 1.

Implants with second-passage periodontal ligament autogenous cell grafts. Low-power (×2.5) photomicrograph of implants and surrounding tissues that did (A) or did not (B) receive an application of enamel matrix derivative (EMD). Higher-power view (×10) of the cervical portion of implant with EMD shows supracrestal projections of bone (C). Same implant viewed in polarized light (E). Photomicrographs of the cervical portion of an implant that did not receive an application of EMD at ×10 (D) and at ×50 (F) magnifications


<sc>Figure</sc>
2.
Figure 2.

Implants with second-passage gingival connective tissue autogenous cell grafts. Low-power (×2.5) photomicrograph of implants and surrounding tissues that did (A) and did not (B) receive an application of enamel matrix derivative (EMD). Higher-power view (×10) of the cervical portion of the implant that did (C) and did not (D) receive an application of EMD


<sc>Figure</sc>
3.
Figure 3.

Implants with gelatin vehicle alone. Low-power (×2.5) photomicrograph of implants and surrounding tissues that did (A) and did not (B) receive an application of enamel matrix derivative (EMD). Higher-power view (×10) of the cervical portion of implants that did (C) or did not (D) receive an application of EMD


Contributor Notes

Ronald G. Craig, DMD, PhD, is with the Departments of Periodontics and Basic Science and Craniofacial Biology, Angela R. Kamer, DM, PhD, and Dennis P. Tarnow, DDS, are with the Department of Periodontics, Sathya P. Kallur, BDS, DDS, MS, is with the Department of Endodontics, and Miho Inoue, PhD, is with the Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY. Dr Inoue is currently with the Faculty of Engineering, University of Tokushima, Tokushima, Japan. Address correspondence to Dr Ronald G. Craig, Department of Basic Science and Craniofacial Biology, New York University College of Dentistry, Mail Code 9436, 345 East 24th Street, New York, NY 10010 (rgc1@nyu.edu).

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