Occlusal forces cause stress which morphologically affects the supporting tissues of implants. The aim of this study was to examine the effects of occlusal forces on the distribution of neurofilament protein (NFP)-positive nerve fibers in the tissue of peri-implant bone. The bilateral 2nd, 3rd and 4th mandibular premolars and the 1st molars were extracted from three mongrel dogs. After 4 months of healing, 4 screw-type implants were inserted in the oral cavity. Three months after insertion, the implants on the molar site were loaded by occlusal forces, while those on the premolar site were unloaded. After a further 3 months, the dogs were sacrificed, and specimens were prepared for immunohistochemical NFP-positive staining by the labeled-streptavidin-biotin method. Many NFP-positive nerve fibers were found in the tissues of the loaded site when compared with the unloaded site. These fibers were localized in both the bone marrow space and in the peri-implant fibrous tissue. They had two types of nerve endings: simple free nerve endings, and nerve endings with tree-like ramifications. The present results suggest that loading by occlusal force causes an increase in the number of NFP-positive nerve fibers, many of which have free nerve endings in the peri-implant tissue. The possible role of these NFP-positive nerve fibers is discussed.

Cystic tumor (endodermal heterotopia) of the atrioventricular (AV) node in a 95-year-old female is described. Electrocardiograms showed complete AV blockage with a narrow QRS morphology resulting from the long-standing first degree of AV blockage since age 61. A cardiac pacemaker was implanted at age 83. The patient died of pneumonia at age 95. Autopsy demonstrated a normal heart weight (320 g), normal coronary artery and normal myocardium. Histological examination of the conduction system revealed a marked fibrotic sinoatrial (SA) node and a cystic lesion in the lower right atrium, including the approaches to the AV node. The bundle of His and its branches were completely intact. Cellular nests and cystically dilated tubules were scattered within a loose tissue stroma, which measured 18 x 12 x 5 mm. There were several mitotic figures among the tubules, as well as nuclear fragments similar to apoptotic bodies and exfoliation of the tumor cells. Immunohistochemical studies demonstrated a positive reaction for epithelial membrane antigen, carcinoembryonic antigen, CA19-9, cytokeratin and secretory component in the tubular cells, and a negative reaction for thrombomodulin. Endocrine cells among the tubules were positive only for calcitonin and serotonin. Ultrastructurally, sparse microvilli and desmosome-like structures between the tumor cells were observed. These findings support that this lesion originates from the endoderm. Moreover, it is likely that progression in the degree of AV block may be explained by the cell proliferation activity of the tumor.

Although titanium alloys are known to be biocompatible with bone tissue after implantation in human beings, the effect of titanium on osteoclasts remains to be studied. We examined the effect of titanium salt on the formation and survival of osteoclasts in cell culture. The addition of 10 microM titanium tetrachloride caused a decrease in the cell number of osteoclast-like cells induced in bone marrow cell cultures taken from mice. The addition of 10 microM titanium tetrachloride caused degradation of the disaggregated osteoclasts taken from neonatal rats and a decrease in bone resorption. Along with the increase in the degradation of osteoclasts, the number of apoptotic cells increased. Titanium tetrachloride dose-dependently decreased the cell number and alkaline phosphatase activity of osteoblastic cell cultures taken from rat calvaria. However, these concentrations were 30-40 times higher than those in the case of osteoclast-like cell formation. These results showed that titanium ions caused a preferential degradation of osteoclasts rather than osteoblasts, most likely by apoptosis.

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