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hemidesmosomes together with mechanical
interdigitation of the innermost cell layer with
the open pores or the implant surface, indicating
the presence of a less vulnerable seal
toward the oral cavity (Schüpbach and
Glauser 2007) (Fig. 12.5f). The connective
tissue compartment also exhibited collagen
functionally oriented toward the implant
surface (Figs. 12.5g, 12.5h) in the form of a
pseudo-gomphosis.
Thus substantial structural analogies can
be demonstrated between gingiva and periimplant
mucosa in humans. In each case,
these tissues provide protection of the underlying
soft tissue and bone. Several specifi c
Chapter 12 The Implant Surface and Biological Response 219
Figure 12.5. a. Schematic diagram illustrating the junctional epithelium (JEP), the connective tissue (CT), and the
alveolar bone crest (B). b. TEM micrograph demonstrating hemidesmosome/basal lamina complexes (red arrows) at the
interface to a machined implant surface as seen following removal of the implant. c. SEM micrograph showing adaptation
of connective tissue (CT) toward a machined implant (IMP) surface (red arrows). d and e. Orientation of the collagen
matrix and fi broblasts parallel to a machined implant surface. Note the avascular scar tissue-like fi ber rich zone (IZ).
f. Schematic diagram illustrating the connective tissue (CT) compartment. g. Polarized light microscopic image showing
functionally oriented collagen fi brils directed toward an oxidized titanium surface. h. SEM image showing connective
tissue fi bers ending in a pore. i. Polarized view of the circumferentially oriented dense fi ber bundles around an implant.
Adapted from Schüpbach and Glauser 2007; permission granted by Elsevier Mosby.
antimicrobial defense mechanisms exist
in the junctional epithelium (Bosshardt and
Lang 2005; Pollanen et al. 2003). As seen
around teeth, leukocytes migrate through the
junctional epithelium and comprise the
most important defense mechanism around
implants (Schüpbach and Glauser 2007).
A Glimpse into the Future
We now realize that micro- and nanotextured
implant surfaces can recapitulate
the bony interface created in natural bone