The Custom Endosteal Implant (CEI): Histology and Case Report of a Retrieved Maxillary Custom Osseous-Integrated Implant Nine Years in Service.

Abstract

Abstract The Custom Endosteal Implant (CEI) is a custom-cast osseo-integrated implant that over the years has evolved to replace the "old" fibro-integrated subperiosteal variant. This newly developed implant achieves osseous integration by utilizing a hydroxyapatite (HA) coating plus a specialized grafting technique that produces much improved success rates relative to its fibro-integrated subperiosteal predecessor. This case reported herewith represents a maxillary CEI implant that was placed and in functional service for nine years before later being retrieved and processed for histologic examination subsequent to the patient's demise. In addition, due to infection that occurred shortly after placement, an early provisional procedure with fluoridated HA was also performed. Histologic analysis of the post-mortem specimen revealed fully integrated new bone formation intimately surrounding the previously dehisced implant strut. The latter had previously been decontaminated and grafted with a thin layer of fluorapatite (FA) material. Results including histologic analysis confirmed complete osseous-integration of the implant following successful FA graft revision.