Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-26T07:55:39.773Z Has data issue: false hasContentIssue false
  • English
  • Français

Can keratinocytes cause failure of osseointegration?

Published online by Cambridge University Press:  09 December 2008

S Khwaja ,
A Curry ,
I H Chaudhry  and
K M J Green
S Khwaja*
Affiliation:
ENT Department of Histopathology, Manchester Royal Infirmary, UK
A Curry
Affiliation:
Health Protection Agency, Clinical Sciences Building, Manchester Royal Infirmary, UK
I H Chaudhry
Affiliation:
Health Protection Agency, Clinical Sciences Building, Manchester Royal Infirmary, UK
K M J Green
Affiliation:
ENT Department of Histopathology, Manchester Royal Infirmary, UK
*
Address for correspondence: Ms S Khwaja, 3 Pexwood, Chadderton, Oldham OL1 2TS, UK. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Aim:

Bone-anchored hearing aids are well established, implanted devices. We present two patients who suffered mixed hearing loss and who underwent titanium implant placement in the temporal bone to enable attachment of bone-anchored hearing aids. Osseointegration is necessary for such implants to function. We report these two cases to highlight how such osseointegration may be disrupted.

Method:

Attached tissue from the explanted or removed titanium implants was examined by transmission electron microscopy and histopathological analysis.

Results:

Attached tissue from both implants showed the presence of keratinocytes at the titanium implant and living bone interface. This was confirmed by histopathological analysis. In one case, there was frank keratinocyte proliferation, which had led to osseointegration failure; in the other case, such proliferation was present but not so advanced.

Conclusion:

These findings suggest that, in the cases reported, keratinocytes implanted between the titanium and the living bone, leading to disruption of osseointegration.

Keywords

Implants And ProsthesesBone-Anchored Hearing AidsTitaniumComplicationsKeratin
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 9 , September 2009 , pp. 1035 - 1038
Copyright
Copyright © JLO (1984) Limited 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Bränemark, PI. Introduction to osseointegration. In: Bränemark, PI, Zarb, GA, Albrektsson, T, eds. Introduction to Osseointegration in Tissue-integrated Prostheses: Osseointegration in Clinical Dentistry. Chicago: Quintessence Publishing, 1985;11–76Google Scholar
2 Albrektsson, T, Bränemark, PI, Hansson, HA, Lindström, J. Osseointegrated titanium implants. Requirements for ensuring a long-lasting, direct bone-to-implant anchorage in man. Acta Orthop Scand 1981;52:155–70CrossRefGoogle ScholarPubMed
3 Drinias, V, Granström, G, Tjellström, A. High age at the time of implant installation is correlated to increased loss of osseointegrated implants in the temporal bone. Clin Implant Dent Rel Res 2007;9:94–9CrossRefGoogle ScholarPubMed
4 Mylanus, EAM, Johansson, CB, Cremers, CWRJ. Craniofacial titanium implants and chronic pain: histological findings. Otol Neurotol 2002;23:920–5CrossRefGoogle Scholar
5 Tjellström, A. Osseointegration systems and their applications in the head and neck. Adv Otolaryngol Head Neck Surg 1989;3:39–70Google Scholar
6 Huisman, MA, de Heer, E, Ten Dijke, P, Grote, JJ. Transforming growth factor beta and wound healing in human cholesteatoma. Laryngoscope 2008;118:94–8CrossRefGoogle ScholarPubMed
7 Mempel, M, Voelcker, V, Kollisch, G, Plank, C, Rad, R, Gerhard, M et al. Toll-like receptor expression in human keratinocytes: nuclear factor kappaB controlled gene activation by Staphylococcus aureus is toll-like receptor 2 but not toll-like receptor 4 or platelet activating factor receptor dependent. J Invest Dermatol 2003;121:1389–96CrossRefGoogle ScholarPubMed
8 Granström, G. Craniofacial osseointegration. Oral Dis 2007;13:261–9CrossRefGoogle ScholarPubMed