A titanium dental implant may be the center of several pathologic processes. It may be an innocent bystander or it may be involved in a host response. A histopathologic exam is often necessary to determine the process and its relation to the implant.
Pathologic processes may be intra-osseous or extra-osseous.
Intra-osseous pathology includes:
(1) chronic osteomyelitis
(2) inflammatory epithelial cyst
(3) inflammatory granuloma
(4) developmental epithelial cyst
(5) metastatic carcinoma
(6) simple bone cyst
Extra-osseous pathology includes:
(1) reactive hyperplasia
(2) pyogenic granulomas
(3) peripheral giant cell granuloma
(4) oral lichenoid lesion
(5) squamous cell carcinoma
(6) peripheral cemento-ossifying fibroma
The most common lesions are reactive hyperplasia, pyogenic granuloma and chronic osteomyelitis.
Metallic particles can be seen in the histopathologic sections. These can be identified by spectrophotometry.
