{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T15:26:58Z","timestamp":1760887618739,"version":"build-2065373602"},"reference-count":0,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2000,8,1]],"date-time":"2000-08-01T00:00:00Z","timestamp":965088000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Periodontology"],"published-print":{"date-parts":[[2000,8]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Spontaneous early exposure of dental implants could interfere with the early healing phase of dental implants. These exposures have been clinically classified according to degree of implant exposure from 0 (intact mucosa) to IV (complete exposure). The characteristics of perforated mucosa (Class I and II) covering submerged dental implants were examined histologically in this study.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Biopsy specimens of 34 Class I and II perforated mucosa covering submerged dental implants were examined histologically. Serial sections were evaluated from the periphery of the specimen to the center of each perforation lesion.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Class I specimens presented hyperplastic epithelium characterized by hyperparakeratosis and acanthosis. Chronic inflammatory cells diffusely infiltrated the connective tissue. Sections closer to the perforation revealed gradual epithelial invagination; in the deepest aspect, there was a cyst\u2010like structure in all Class I specimens examined. A thin layer of connective tissue containing necrotic material and debris formed the \u201ccystic\u201d wall proximal to the implant cover screw. Class II specimens presented the same epithelial patterns; however, the cystic structures were replaced by direct contact between the cover screw and the oral cavity via the perforation.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Spontaneous early perforations are the sequela of either traumatic irritation or failure of the tissue flaps to produce primary healing. Most Class I perforations include epithelial invagination and the formation of a cyst\u2010like structure. Necrosis of the base of the \u201ccyst\u201d or enlargement of the perforation results in direct communication between the oral cavity and the covering screw surface (Class II). <jats:italic>J Periodontol 2000;71:1231\u20101235.<\/jats:italic><\/jats:p>","DOI":"10.1902\/jop.2000.71.8.1231","type":"journal-article","created":{"date-parts":[[2005,2,2]],"date-time":"2005-02-02T06:39:40Z","timestamp":1107326380000},"page":"1231-1235","source":"Crossref","is-referenced-by-count":13,"title":["Spontaneous Early Exposure of Submerged Implants: III. Histopathology of Perforated Mucosa Covering Submerged Implants"],"prefix":"10.1002","volume":"71","author":[{"given":"Haim","family":"Tal","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Dayan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2000,8]]},"container-title":["Journal of Periodontology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/pdf\/10.1902\/jop.2000.71.8.1231","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T10:01:52Z","timestamp":1760868112000},"score":1,"resource":{"primary":{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/10.1902\/jop.2000.71.8.1231"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,8]]},"references-count":0,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2000,8]]}},"alternative-id":["10.1902\/jop.2000.71.8.1231"],"URL":"https:\/\/doi.org\/10.1902\/jop.2000.71.8.1231","archive":["Portico"],"relation":{},"ISSN":["0022-3492","1943-3670"],"issn-type":[{"type":"print","value":"0022-3492"},{"type":"electronic","value":"1943-3670"}],"subject":[],"published":{"date-parts":[[2000,8]]}}}