アピカルインプラント (Apical-Implant) に関する実験的研究

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With rapid progress in the field of metallurgy an alloy composed of Co-Cr-Mo was explored in 1929, and by 1936 Venable and his coworkers put forth evidences that the alloy had an excellent feature in showing biological compatibility with the living tissues. Since then the alloy found wide use in many branches of medicine, and particularly in dentistry is has become a material of choice in manufacturing a variety of metal implants. The present author has devised an apical metal implant made of Co-Cr alloy and administered it to each of a total of 22 adult dogs whose teeth were operated with the apical resection. Possible change to be expected to occur at the neighboring tissues by the surgical attack and insertion of the implant was studied with radiological and pathohistological procedures. Results were summarized as follows. 1. In the manufacture of the metal implant, care was taken to shape it as likely as possible to the form of the apex of root to be removed by resection, and this was placed in position. 2. For successful result of operation, the present author recommends that the relative position of the metal implant should be placed as near as possible to the middle of the bone defect created by the operation, and it is also hoped that needlessly wide penetration in the alveolar bone should be avoided because the smallest possible bone defect would promise a better result. 3. In order to prevent any possible resorption of resected end of the root and to keep the inserted metal implant from dislodging, the author made use of "canals", a root filling agent of commercial source, as adhesive, and this proved successful because in most of the experiments hardly any resorption was observed, nor was there any one case of dislodging of the metal implant applied. 4. In case where the adhesive " Canals" was omitted from using, resorption of the resected end of the root was observed in a majority of cases. 5. On the other hand, when a surplus quantity of the adhesive agent happened to overflow from the junction of the implant, the adhesive caused a reactive influammation of considerable duration in adjacent tissues and brought about retardation of wound repair. 6. The X-ray findings revealed that by 3 to 4 weeks after administration of surgical operation for metal implant there was observed first sign of reduction of the bone defect. Of all cases of the present experiments the most favorable course of wound healing was achieved in those cases in which the initial boundary of the bone defect became almost lost in obscurity with apposition of new bone by about 13 weeks after operation. On the contrary, although the first reduction of bone defect was seen by 4 to 6 weeks after operation in some cases, no further improvement was not observed in the subsequent weeks or even after 14 to 16 weeks, and such cases proved to be the failure of whole operation. 7. Histological examinations on the cases of excellent prognosis showed the apposition of new bone at the periphery of metal implant, and the spaces between the implant and bone tissues were filled with thin layers of fibrous connective tissue, running parallel along the course of metal implant and lacking any sign of inflammatory cell infiltration. This tissue of connective fibers may be the socalled Peri-implantium. 8. Histological examinations on the cases of unfavorable prognosis showed the presence of granular tissues with inflammatory cell infiltration filling the spaces between the metal implant and its peripheral bone tissue, and in some such cases there lacked any sign of appearance of socalled Peri-implantium with retardation of new apposition of bone tissue, Further, in some other instances, there were seen growth of epithelial tissues and sometimes formation of abscess in parts of the bone tissue surrounding the implant. 9. Results obtained in the present study were not always satisfactory for purpose of direct clinical application. Although the present author's experience was much limited, it suggested above all the need of a less irritant sort of adhesive agent than the one used in the study. If it were possible to seal the junction between the metal implant and the resected end of root with such a non-irritant adhesive, undesired growth of any soft tissues into the new bone tissue as well as resorption of resected end of root would by no means occur, and it would give promise of a beneficial result.
九州歯科学会の論文
1976-01-31

アピカルインプラント (Apical-Implant) に関する実験的研究

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