Biologic width around titanium implants. A physiologically formed and stable dimension over time

Research in implant dentistry has mainly focused on hard tissue integration with much less data available with regards to soft tissue integration invo lving epithelium and connective tissue. In the present study, the implantog ingival junction of unloaded and loaded non-submerged titanium implants has been analyzed histometrically in the canine mandible. In 6 foxhounds, 69 i mplants were placed. Dogs in the unloaded group were sacrificed 3 months af ter implant placement. Loaded implants were restored with gold crowns and t hose dogs were sacrificed after 3 months and 12 months of loading. Non-deca lcified histologic sections were analyzed histometrically measuring the dim ensions of the Sulcus Depth (SD), the Junctional Epithelium (JE), and the C onnective Tissue Contact (CTC). Histometric evaluation revealed that signif icant changes within tissue compartments (SD, JE, CTC) occurred over time ( P<0.05). Sulcus Depth had a mean of 0.49 mm and 0.50 mm after 3 months and 6 months of healing, but after 15 months was 0.16 mm which was significantl y different. Similarly, the length of the Junctional Epithelium after 3 mon ths and 6 months of healing was 1.16 mm and 1.44 mm, respectively, and thes e values were significantly different from measurements taken after 15 mont hs(1.88 mm). The area of Connective Tissue Contact showed a different patte rn of change in that after 3 months of healing (1.36 mm) it was significant ly different from the same area after 6 months and 15 months which were 1.0 1 mm and 1.05 mm, respectively. Interestingly, the sum of SD, JE, and CTC, forming the Biologic Width, did not change over the observation period (P>0 .05). These data indicate that the Biologic Width is a physiologically form ed and stable structure over time in the case of non-submerged, one-piece t itanium implants as evaluated histometrically under unloaded and loaded con ditions. Dynamic changes did occur, however, within the overall Biologic Wi dth dimension. Thus, the use of non-submerged, one-piece implants allow for stable overall peri-implant soft tissues as evaluated under loaded conditi ons for up to 12 months.