Dental Implants and Osseointegration

Osseointegration is derived from the Greek osteon, bone, and the Latin integrate, to make whole. It is the phenomenon responsible for formation of a direct contact between titanium dental implants and the bone which they are placed. The bone grows right up to the surface of the dental implant, without an intervening layer of soft tissue. developing a close bond and fixing the dental implant in place.

History of Dental Implant Osseointegration

Implant osseointegration was first discovered in the 1950’s by Swedish orthopaedic surgeon Per-Ingvar Brånemark. fHe used a titanium implant chamber to study the blood flow in Rabbit bone. However, when he tried to remove the implant he was unable as it had completely fused to the bone and called his finding “osseointegration”. His theory suggested that titanium oxide permanently fuses with the bone, fixing the implant in place. In 1965 Brånemark placed the first dental implants into a human patient, inventing a new treatment option that would dramatically change the field of dentistry.

Factors influencing Osseointegration

Once a dental implant has been installed and bone starts to grown into it, it’s impossible to remove the implant without damaging the bone. The degree in which the bone is integrated with the implant is affected mainly by the following factors:

• Dental Implant Material – It was originally believed that osseointegration was unique to titanium of a high purity, however while this forms to the basis of dental implant treatment today there are a wide range of materials that can integrate with bone. Other materials include Zirconium dental implants and certain ceramics such as hydroxyapatite however these have not been extensively researched in a clinic environment.
• The surface and structure of the implant – The ability of highly pure titanium to osseointegrate so well with bone is thought to be due to the titanium oxide layer that forms on the surface of the implant, described as being osseoconductive as it’s conductive to bone formation. Modifications of the surface of the implant have been made by multiple dental implant manufacturers to increase its biocombatibility and speed up the rate of osseointegration.
• Heat – Heating of the bone during implant surgery to temperatures of more than 50oC can result in cell death and preventive the osseointegration of implants. Great care is taken at implant sites to prevent an increase of temperature, which has led to intelligent drill speed design.

Other Applications of Osseointegrated Implants

The advantages of Osseointegration aren’t just utilised in Dental Implants, the potential in the field of prosthetics is limitless. With osseointegrated prosthetics, prosthetic limbs can be integrated into the bone allowing them to seat firmly without causing pain or limiting a patients freedom of movement. In the case of severely broken bones rods can be osseointegrated to stabilise the bone while it heals and adds support to prevent the bone being broken again. The process of osseointegration has also been used in artificial ears, eyes and noses with a high degree of success.

What started off with a rabbit has led to an advance in dentistry that allows patients to replace their missing teeth effectively. The osseointegration of dental implants into the bone of a patients jaw allows significant load bearing, allowing them the freedom to eat most foods and making dental implants the best solution in replacing missing teeth.