1990-28-2
(1).
,


(2, 3, 4, 5).
, ,

(2)(6)
.

.
(7, 8),
(9, 10, 11), (12, 13, 14) ,
,
, , ,

,Gross (15)
Garrington (16) , ,

, Hench(17)



. Hansson(18), Brånemark(19), Baro
20)

. Laing(21) Albrektsson(22)

.

. Bodine(23), Babbush(24),
Linkow(25) blade
— 1—


,
1970 . 1980
Albrektssom(22, 26, 27), Brånemark
(19, 28, 29, 30), Zarb(31, 32), Carlsson (33), Linter (34), Cook (35), Wie (36), Akagawa (37),
Niznick(38), Hansson (18, 39)

. Weiss(40, 41)

,
Brunski(42)
.
Brånemark 1952

, 1965


(19, 38, 46) Brånemark
.
,
, , 2 .



, .
() , ,
, , fluorochrome dye
, , ,
, ,
. , , ,

. , , , ,

.
Osseointegration
,
(43), &(44)

.
2



.
.
, 3 Table
.
)
a) (45)
1, 2, 3 1, 2, 3

6 .

1/2
, 1 2 3 5

.

,
10mm 5
, 3
2, 1, 1/2
.
Adell(46), Niznick(47), Kim(48)
(Fig. 2).
X-
.
cephalic, veim kg 20-25mg
pentothal sodium
5% . 3
,
1cm
2,5% glutaraldehyde
(0.1Mcacodylate : pH 7.4)
1%OsO(0.1M cacodylate ) .
b)

0.1M EDTA

BP Knife #15 ,
, 4-6
H-E . Epon 812
1 1%toluidine
blue .
1200 .
— 3—
Fig.1. Photograph of implants used in this study. From the left Brånemark Corevent, and Kimplant.
Fig.2. Schematic drawing of Experimental implants inserted in the mandible of dog.
.

. 3 ,
, .
15, 1, 2
, 3
serew core ,
(Fig.
3)

, Kimplant
.
,

.

.
2) 15

.

.
,
.
3) 1

,
.
.
5) 3
Havers ,


.
(endoplasmicreticulum)
(ruffled border) Golgi,
(mitochondria),(vaculoe)
.
.
Fig.3. Schematic drawing of preliminarysectioning for the prepapation of light and electron microscopic examination slides
.
,

. Havard-NIH
(49, 50) Toronto (51, 52)
, ,
, 5, 10

— 5—
(Table ).
, Meenaghan(53)
3
, ,
, James(54)



. Albreksson(22)
, ,
,
,
.

()
(matte) .
James(54), Klawitter(55), Deporter(56), Hulbert
,

(saucerization)
()
.

200

,

. Cook(59)

, pillar(60)
.
, cylinder
,
Carlsson(62)
.

kimplant

( 38, 39,

.
— 6—
.
Baier(64), Carter(65), parsegian(66)
(wettability)
glow discharge
. Kasemo(67)
10
,
.


.


, Baro(68) 3
30nm 0.11 micron
, 50-100
dielectric constant
.
Clark Hickman(69)
ABE vitallium stainless
. Cook
70)C.P. hydroxylapatite Ti-6 AI-4v
alloy 1.54Mpa
7.27Mpa , Zitter(71) redox
system (current
density) , Stainless steel
,
.
6%aluminium, 4% vanadium
, C.P. 60%
Albrektsson(72) proteoglycans
glucoseaminoglycans
.
Albrektsson(73)



Fig.4 . Linder(74) 12
3 50-100
oxide, 100-200 proteoglycan, 200-
500 collagen filament
, ,
. 2
titanium oxide, proteoglycan
(
36), 3 porteoglycan(37)
, ,
.
Andersson(76)
,

— 7—
Fig.4. Artistic sketch of the microscopic detail of the interface between an osseointegrated titanium implant and bone.
, Salthous(77)
,
24
, Anderson(78)
, ,


. Gross(15)
, , ()
, ()

.

( 25, 27),


.
tapping insertion
non-tapping
insertion
.
tapping
non-tapping
kimplant Brånemark

drill . tapping

Brånemark kimplant (
28 ,
150
.

.
- , fixture

. Brånemark (18, 28, 46)

3-6
, (83) 1-2
.
3
3
.
screw 50%
28%
.

3


100%
.
, , ()

,
.

, 2
3
.
Brånemark
2000rpm drill
tapping fixture 15-20rpm drill


15
— 8—
Linder(87) epoxy()
,
Thomson(88) Lausmaa(89)
()
.


.

(SEM)

( 38, 39, 40).



. 15
, 2


.


.
hemidesmosome ,
glow discharge



.
Brånemark,
Core-vent
Kimplant

,

.
.
, 1 2
.
, 3
.

.

.
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— 13—
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EXPLANATIONS OF PHOTOMICROGRAPHS
1.Note the microfracture of compact bone and vital osteocyte at the implant-tissue
interface. Immediate after implantation of Brånemark. Toluidine blue(x400).
2. Note the bone contacted with implant. 15days after implantation of Brånemark.
Toluidine blue(x100).
3. Note the spongy bone implant-tissue interface.
15 days after implation of Brånemark. Toluidine blue(x100).
4. High magnification of 3. Note the osteoblastic bone formation at the implant-tissue
interface. 15 days after implation of Brånemark. Toluidine blue(x400).
5. High magnification of 3. Note the thin, flat cellular layer interposed between implant
and bone tissue. Toluidine blue(x400).
6. Note the osteoclastic bone resorption at the internal surface of bone.
15days after implantation of Brånemark. Toluidine blue(x100).
7. Note the marrow tissue and bone tissue contacted with implant. 1 month after
implantation of Brånemark. H-E(x100).
l month after implantation of Brånemark. Toluidine blue(x400).
9. Note the fibrous tissue contacted with implant. 1 month after implantation of
Brånemark. Toluidine blue(x100).
10. High magnification of 9. Fibrous tissue contains active fibroblasts arranged parallel
to the implant surface.
Note the osteoblastic bone formation at t the surface of bone. Toluidine blue(x400).
11. Note the spongy bone contacted with implant.
2 month after implantation of Brånemark. H-E(x100).
12. Note the thin, flat cellular layer interposed between implant and bone tissue.
2 month after implantation of Brånemark. Toluidine blue(x400).
13. Note the well-formed compact bone at the implant-tissue interface.
3 month after implantation of Brånemark. Toluidine blue(x100).
14. High magnification of 13.
Note the compact bone contacted with implant
3 month after implantation of Brånemark. Toluidine blue(x400)
15. Note the smooth bone surface at the implant-tissue interface
` Immediate after implantation of Core-vent. Toluidine blue(x400).
16. Note the osteoclastic boneresorption.
15 days after implantation of Core-vent. Toluidine blue(x400).
17. Note the bone and marrow tissue contacted with implant.
1 month after implantation of Core-vent. Toluidine blue(x100).
— 15—
1 month after implantation of Core-vent. Toluidine blue(x400).
19. Note the compact bone and marrow tissue contacted with implant.
3 month after implantation of Core-vent. Toluidine blue(x100).
20. High magnification of 19. Note the osteoblastic bone formation at the implant-tissue
interface.
3 month after implantation of Core-vent. Toluidine blue(x400).
21. Note the microcrack of compact bone at the implant-tissue interface.
Osteocytes in the superficial are vital.
Immediate after implantation of kim plant. Toluidine blue(x400).
22. Note the blood clot at the implant-tissue interface.
Immediate after implantation of kim plant. Toluidine blue(x400).
23. Note the compact bone & marrow tissue contacted with implant.
15 days after implantation of kim plant. Toluidine blue(x100).
24. High magnification of 23. Note the osteoclastic bone resorption(arrow head) and
well-developed blood wessels in the inner site of marrow tissue. Osteoblasts form bone matrix
in the implant-tissue interface. Toluidine blue(x400).
25. Note the marrow tissue and bone trabeculae contacted with implant.
2 months after implantation of kim plant. Toluidine blue(x100).
26. High magnification of 25.
Note osteoblasts lining the bone surface at the interface of tissue-implant. Toluidine
blue(x400).
Note the osteoblastic bone formation at the tissue-implant interface. Inflammatory cells
infiltrated in the marrow tissue. Toluidine blue(x400).
28. Note the well-formed compact bone at the implant-tissue interface.
Haversian systems are shown at the compact bone.
3 months after implantation of kim plant. H-E(x100).
29. Electron microgragh of fine granular layer lining the exposed bone.
Immediate after implantation of Brånemark.(x24,000).
30. Electron microgragh of active osteoblast showing abundunt rough endoplasmic
reticlum and mitochondria. Golgi complex(G) near the blood Vessels.
15 days after implantation of Brånemark.(x4,000).
31. Electron microgragh of an osteoblast at the bone resorption site.
The cytoplasm contatins numerous mitochondria, vacuoles, well-developed ruffing(R) and clear
zone(C) are shown. 15 days after implantation of Brånemark.(x4,000).
32. High magnification of ruffled border of 31.(x50,000)
Note the well-developed microprojections.
33. Electron microgragh of an osteocyte in the vicinity of implant.
— 16—
The cytoplasm contains a few mitochondira, rough endoplasmic reticulum. A small portion of a
slender cell process can be seen entering a canalicule(C). Tissue-implant interface is bone
matrix. 15 days after implantation of Brånemark.(x12,000).
34. Electron microgragh of fiberblast-like cells at the implant-tissue interface. They
have a large oval nucleus and a prominent nucleous.
The cytoplasm contains abundant rough endoplasmic reticulum, electron dense granules and a
few mitochondria. Newly formed collagen fibers are present in the intercellular matrix. 1 month
after implantation of Brånemark.(x8,000).
35. Electron microgragh of tissue- implant interface. Note the bone collagen fibers
exposed to the implant(x12,000).
36. Electron microgragh of interfacial layer of bone at the 2 months after implantation
of Brånemark. Electron dense layer lines the interface between the implant and matrix.
Amorphous fine granular layer interposed between the electron dense layer and bone
matrix(x12,000).
37. Electron microgragh of interfacial layer of bone at the 3 months after implantation
of Brånemark. Discontinuous electron dense layer lines the interface. Collagen fibers are
parallel to implant surface. Osteocyte is in its lacuna in the mineralized bone
38. SEM show threated surface of Brånemark implant and tissue remnants attatched to
te implants(×40).
39. SEM shows hollow basket and threaded surface of Core-vent implant, and shows
tissue remnants attatched to the implant(×40)
40. SEM show threated and relatively rough surface of implant, and shows tissue
remnants attatched to the implant(×40)
— 17—
— 18—
= Abstract =
A HISTOLOGIC STUDY OF THE OSSEOINTEGRATION PROCESS TO THE TITANIUM TOOTH ROOT IMPLANT
Chang Young Ahn, D.D.S., Yung Soo Kim, D.D.S., M.S.D., Ph.D., M.Sc.
Department of Prosthodontics, College of Dentistry, Seoul Naitonal University
The severe atrophic edentulism with poor neuromuscular control militates against successful
conventional denture therapy. To such situation, a prescribing of dental implant treatment has
been considered with some probability.
Implant materials used as a trial for dental implants includes metals, plastic polymers and
ceramics.
The purpose of this study was to observe histologic response in osseointegration process at
titanium implant-tissue interface based on biocompatibility at specific period of sequential natures
which were divided into a half month, one, month, two months, three months and immediate as a
base line.
In this study, unilateral lower left premolar and molar teeth were extraced in three dogs. After
allowing to heal for 6 months, three kinds of osseointegrated implant, Brånemark, Corevent and
kimplant(a prototype of SNU implant study)were inserted in each dog respectively according to
the above sequence from front to back. The specimens were taken from those dogs at the same
time since implant were inserted quite reverse order of the specified periods, and decalcified and
processed for histologic examination for the light microscopy and the electron microscopy.
The microscopic histologic findings at the interface between titanium implants and tissue were
interpretated as follows :
A. Light microscopic findings :
a. Immediate : Implant were surrounded by compact bone and spongy bone. Microcrak was
observed in the superficial bone tissue. Osteocytes were disappeared and bone lacunae were
observed as a vacant space in some parts. In the contacting with the spongy bone, bone
trabeculae and bone marrow were in contact with the implant.
b. A half Month : Osteoblasts exist as a monolayer in th inner bone trabeculae and do bone
additiocn. Osteoblasts&inflammatory cells were observed in some parts.
— 27—
c. One Month : The presence of osteoclasts decreased. Osteoblasts did active bone fromation,
and bone marrow was in contact with the implant in the many places.
d. Two Months : Bone formation was advanced in comparison with the b and c. The presence
of osteoclsts was not observed.
e. Three Months : The superficial bone tissue contacted with the implants was entirely
composed by the compact bone.
B. Electron microscopic findings :
a. A half month and one month group : In the parts of the active bone formation, osteoblasts
with the well developed endoplasmic reticulum and Golgi apparatus were arranged in the
monolayer. In the parts of the bone resorption, ruffled border was well developed and many
osteoclasts with the well-developed golgi apparatus, mitochondria, vacuole, vesicle and
lysosome were existed.
b. Three months group : No osteoblasts were observed in the superficial bone tissue. Bone
matrix with collaen fiber was observed.
c. No significant dirrerence in the histologic findings was observed in Brånemark, Core-vent
and kimplant.