Osseointegration Of Dental Implants

Dental Implants

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Osseointegration Introduction or Osseointegration Definition

Osseointegration Of Dental Implants

• In the 1950s, Per-Ingvar Brånemark, a Swedish professor of anatomy, had a serendipitous finding while studying blood circulation in bone that became a historical breakthrough in medicine. He discovered an intimate bone-to-implant apposition with titanium that offered sufficient strength to cope with load transfer. He called the phenomenon osseointegration and developed an implant system with a specific protocol to predictably achieve it.
• Histologically, osseointegration is defined as the direct structural and functional connection between ordered, living bone and the surface of a load-bearing implant without intervening soft tissues.
• Clinically, osseointegration is the rigid fixation of an alloplastic material (implant) in bone with the ability to withstand occlusal forces.
• Branemark also stated that the implant should not be loaded during healing period for osseous integration to occur.
• Osseointegration is a clinically asymptomatic rigid fixation of the implant within bone, during functional loading.
• There is no connective tissue intervening between bone and implant so the interface is strong one which can withstand the occlusal loads.
• Interface consists of remodeled bony tissue. To develop this strong interface, the implant should not be overloaded during its organization period (Soon after placement of implant).
• During this period, the surgical area undergoes a remodeling process just like an extraction site.
• During organization the bone grows into the irregularities of the implant surface
• Hydroxyapatite coated implant get “Biointegrated” with the bone tissue.

Read And Learn More: Periodontics Question And Answers

Basic Principles of Implant Therapy to Achieve Osseointegration

• Implants must be sterile and made of a biocompatible material (e.g., titanium).
• Implant site should be prepared under sterile conditions.
• Implant site should be prepared with an atraumatic surgical technique that avoids overheating of the bone during preparation of the recipient site.
• Implants should be placed with good initial stability.
• Implants should be allowed to heal without loading or micromovement (i.e., undisturbed healing period to allow for osseointegration) for 2 to 4 or 4 to 6 months, depending on the bone density, bone maturation, and implant stability.

Stages of Osseointegration or Osseointegration Process

Factor Affecting Osseointegration

Overload: It causes failure of osseointegration. Premature loading of implant at the time of healing leads to fibrous encapsulation and not osseointegration.

• Biocompatibility of the material.
• Implant design: Most conductive design for osseointegration is cylindrical.
• Implant surface: Implant with mild surface roughness leads to more osseointegration.
• Surgical site: A healthy site is required previously irradiated area is contraindicated.
• Surgical technique: Minimum possible trauma. Surgical drilling should be intermittent, slow rate and is by using sharp instrument.
• Infection control: Infection especially form the periodontium should be avoided.