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.