Abscess Formation Around a Hydroxyapatite-Coated Implant Placed into the Extraction Socket with Autogenous Bone Graft. A Histological Study Using Light Microscopy, Image Processing, and Confocal Laser Scanning Microscopy

THE PURPOSE OF THIS STUDY was to evaluate the radiologic, histologic, and histometric findings for a retrieved hydroxyapatite (HA)-coated implant which had been placed into a fresh extraction socket with autogenous bone graft 3 months previously. A periapical radiograph disclosed a vertical bone loss around the implant cervix. Examination of histologic sections disclosed that granulation tissue including bone chips around the cervix, and newly-formed bone tissue around the grafted bone tissue on the HA coated surface. In the confocal laser scanning microscopic findings toluidine blue-negative bone tissue showed autofluorescence. Histometric analysis indicated that the average percent bone contact was 29.2% (ranged 26.4% to 34.1%). Suspected reasons for failure were an early exposure of the barrier membrane, its early removal, the implant placement into an infected site, inadequate antibiotic premedication, and/or poor control of infections around teeth prior to implant surgery and around implants before and after placement of barrier membrane.