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ePaper created 2015-09-15, 12:06:46 | version 1.38.0
I case report Fig. 9_Implant #007 (ZBM) at 100× magnification. Fig. 10_Implant #007 (ZBM) at 400× magnification. Fig. 11_Implant #0011 (ZBM Kontr.) at 30× magnification: bone-level implant, blasted and not etched. Fig. 12_Implant #0011 (ZBM Kontr.) at 100× magnification: the surface appears rather metallic. _Materials and methods Allofthepatientsinthisstudyreceivedmorethan one implant. Some of them lost more than one, and implants with the same fabrication numbers failed in all of these patients. While ten implants where re- claimed, six explanted implants were compared with six sterile-packaged ones of the same fabrication number. All of the examined implants were analysed underalightmicroscopeatamagnificationof30×to 300×. The packaged implants were thoroughly checked in terms of accuracy of the information on the packaging. Thefollowingimplantregionswereexaminedun- der the microscope: – implant collar, swift to threads – middle of implant body with trapezoidal thread, swift to triangular threads – apical of implant body, sharp triangular cutting threads – suspicious regions on the explanted implants – regions showing evident defect under minimal magnification – regions with no evident bone on-growth – regions with tissue residue. _Results Implants#001,0014,0015,002and007 Implant#001,correlatingto#002,showedmassive surface defects, especially on the thread crest. At 30× magnification, irregularities in the surface roughness wereevident.Ahybridityoftheroughnesswasnotde- tectible.At100×,partsonthecrestalimplantbodywith sandingmarksandnosurfacetreatmentwereobserved. At 300×, structural defects due to blasting media and massive residue could be seen. Besides production faults,therewasareducedandirregularroughness.We alsomadefindingsthatcouldnotbespecified,butthat includedartificialandfaultydefects(Figs.1–10). Implants#0011,0013and006 Implant #0011 was only blasted and not etched. It was a bone-level implant. Apart from blasting media residuecoveringthewholeimplantbody,wedetected metalcuttings.Thepresenceofsuchcuttingscouldbe explained as being due to deficient cleaning proce- duresandpoorqualitycontrol,sincesuchcontamina- tion was apparently not detected. Generally, the sur- faceappearedrathermetallic.Reflectionelectronmi- croscopy would help determine micro-roughness (Figs. 11–13). Implants #0012, 003, 004 and 005, correlating to #17, 18and19 These implants exhibited a more precise thread de- sign and surface treatment. The metallic lustre of the surface and the major blasting media defects on the crest of the threads were prominent. The thread flanks showed no macrostructure, so we found also in these implantsanirregularsurfaceroughness.Themostseri- ousissueinthisgroupwasthelabellingoftheimplants asbonelevelalthoughtheimplantshadamachinedcol- larinside(Figs.14–16). Bone-level implants with platform switching are placeddifferentlytoimplantswithamachinedcollar. 20 I implants3_2015 Fig. 9 Fig. 10 Fig. 11 Fig. 12