Experience with percutaneous titanium implants in the head and neck: a clinical and histological study.

Percutaneous implants have been associated with numerous problems. However, by using skin-penetrating, bone-anchored titanium implants, developed by Professor Brånemark at the Department of Anatomy, University of Göteborg, good long-term results have been observed. These implants have been in clinical use for anchorage of bone-conducting hearing aids and facial prostheses since 1977 and 1979, respectively. The total number of implants is approximately 700. Less than 4% of the observations have shown significant irritation. Biopsies from 33 patients were collected for histological studies. In the irritated skin there was an increased number of inflammatory cells, mainly polymorphonuclear cells, B-cells, and plasma cells but not T-cells. This suggests a response directed against exogenous agents rather than an allergic reaction against the implant per se.