[Endosteal stimulation in implantology. Study and results after 2 years].

Analysis of implant failure in the maxilla has showed that these failures were predominant on bone that had remained toothless for a period exceeding 2 years. Histological and osseostructural studies demonstrate that the loss of maxillary teeth has an essential effect on its vascularisation, more than on the bone loss; this vascularisation is absolutely necessary in order to obtain an adequate and lasting osseointegration. When, after surgical preparation of the receiver bony site, no bleeding is noted, insertion of the implant is postponed. Six weeks later, the new socket is curetted and the scar tissue removed; this showed that, systematically, the vascularisation was markedly increased. Results at 2 years of this "endostal stimulation", applied to Brånemark and I.M.Z. implants, are: 95.5% success in the maxilla, compared to 83% with osseointegration during the same period. This technique may be applied in the posterior mandibular area, when there is a marked resorption and the short implant is only inserted in cortical bone, minimally vascularized, because of the presence of the mandibular canal; the results of this latter technique are actually poor.