3. Osseointegration derives from ‘osteon,’ the
Greek word for bone and the Latin word for
‘to make whole’ which is integrate.
This refers to the process that will take place
between the living bone and the surface of
implant.
4. The concept of Osseointegration was developed and
the term was coined by Dr. Per-Ingvar Branemark,
Professor at the institute for Applied Biotechnology,
University of Goteborg, Sweden .
5. In 1952 ,Vital microscopy studies in rabbits
using titanium optic chambers.
.
10. Structurally oriented definition “Direct structural and
functional connection between the ordered, living
bone and the surface of load carrying implants”. -
Branemark and associates (1977)
“The apparent direct attachment or connection of
osseous tissue to an inert, alloplastic material
without intervening connective tissue”. - GPT 8
11. “It is a process where by clinically asymptomatic
rigid fixation of alloplastic material is achieved
and maintained in bone during functional
loading” - Zarb andT Albrektsson (1991)
Histologically, Direct anchorage of an implant by the
formation of bone directly on the surface of an implant
without any intervening layer of fibrous tissue. -
Albrektsson and Johnson (2001)
12. Clinically Ankylosis of the implant bone
interface.“Functional ankylosis” -Schroeder and
colleagues (1976)
Biomechanically oriented definition
“Attachment resistant to shear as well
as tensile forces” - Steinmann et al
(1986).
13. American Academy of Implant Dentistry (AAID)
defined Osseointegration as "contact established
without interposition of non-bone tissue between
normal remodeled bone and an implant entailing a
sustained transfer and distribution of load from the
implant to and within the bone tissue"
15. Meffert et al (1987)
ADAPTIVE- OSSEOINTEGRATION
BIOINTEGRATION
Osseointegration
16. In 1986,the American Academy of Implant Dentistry(AAID) defined Fibrointegration as
“Tissue to implant contact with interposition healthy dense collagenous tissue between
the implant and bone’’
17. Presence of connective tissue between the implant
and bone .
Collagen fibers functions similarly to Sharpey’s
fibers found in natural dentition.
The fibers are arranged irregularly, parallel to the
implant body, when forces are applied they are not
transmitted through the fibers.
“Pseudoligament”, “Periimplant ligament”, “Periimplant
membrane”.
18. No real evidence
Forces are not transmitted through the fibers -
remodeling was not expected .
Forces applied resulted in widening fibrous
encapsulation, inflammatory reactions, and
gradual bone resorption there by leading to
failure.
19. • Healing process may be primary bone healing or
secondary bone healing.
• In primary bone healing, there is well organized
bone formation with minimal granulation tissue
formation - ideal
• Secondary bone healing may have granulation
tissue formation and infection at the site,
prolonging healing period. (Fibrocartilage is
sometimes formed instead of bone – undesirable)
20. The device
Two consecutive profiles of the pitch.
U shaped circumferential trough.
Pitch engages hard tissue walls
Void between pitch and body of implant – wound chamber.
Berglundh et al (2003) and
Abrahamsson et al (2004).
21. The wound chamber
Blood clot
Erythrocytes, neutrophils and monocytes
Leukocytes – cleansing process.
22.
23. Fibroplasia
4 days of healing
Coagulum replaced by granulation tissue.
Mesenchymal cells, matrix components
Angiogenesis.
Provisional connective tissue.
24. Bone modelling
1 week of healing
Vascular structures with few inflammatory cells.
Cell rich immature (WOVEN) bone.
(Centre of chamber and direct contact of implant surface.)
1st phase of osseointegration.
25. 2 weeks
woven bone pronounced.
Woven bone extends from parent bone into connective
tissue.
Mature osseointegration
Pitch – ongoing new bone formation
Recipient site immediate to implant in direct contact –
bone resorption with new bone formation.
4 weeks
Cell-rich woven bone covered most of titanium.
Central portion – primary spongiosa – vascular
structures and mesenchymal cells.
26.
27. Remodelling
After 6-12 weeks – mineralised bone.
Primary and secondary osteons
Bone marrow, adipocytes and mesenchymal cells.
39. Woven callus
Woven bone is formed at implant site.
Primitive type of bone tissue and
characterized Random, felt-like orientation of
collagen fibrils
Numerous irregularly shaped osteocytes
Relatively low mineral density
40. Lamellar compaction
The woven callus matures as it is replaced by
lamellar bone.
This stage helps in achieving sufficient
strength for loading.
41. Interface remodeling
This stage begins at the same time when
woven callus is completing lamellar
compaction.
During this stage callus starts to resorb, and
remodeling of devitalized interface begins.
The interface remodeling helps in
establishing a viable interface between the
implant and original bone.
42. Compact bone maturation
During this stage compact bone matures by
series of modeling and remodeling processes.
The callus volume is decreased and interface
remodeling continues.
43.
44.
45.
46.
47. Distance Osteogenesis :
A gradual process of bone healing inward from the
edge of the osteotomy toward the implant. Bone
does not grow directly on the implant surface.
48. • The direct migration of bone-building cells
through the clot matrix to the implant surface.
• Bone is quickly formed directly on the implant
surface.
49. (Davies - 1998) Contact osteogenesis :
EARLY PHASES OF
OSTEOGENIC CELL MIGRATION
(OSTEOCONDUCTION)
DE NOVO BONE FORMATION
BONE REMODELING AT
DISCRETE SITES.
102. Int J Oral Maxillofac Implants. 1986 Summer;1(1):11-25.
The long-term efficacy of currently used dental implants: a
review and proposed criteria of success.
AlbrektssonT, Zarb G, Worthington P, Eriksson AR.
103.
104.
105.
106.
107.
108.
109.
110. Osseoperception is defined as mechanoreception in the absence of a functional
periodontal mechanoreceptive input but derived from temporomandibular
joint (TMJ)
111.
112.
113.
114. •Thorough understanding and application of factors
affecting the osseointegration and biological process of
osseointegration in clinical practice is the key factor for
success.
• The “osseointegration” is a multifactorial entity.
• Achieving the osseointegration of the endosteal
dental implants needs understanding of the many
clinical parameters.
115. Hobo, Ichida, Garcia “Osseointegration and occlusal
rehabilitation” Quintessence Publishing.
Jan Lindhe “Clinical periodontology and implant
dentistry” 4th edition, Blackwell Publishing.
Elaine McClarence “Branemark and the development of
osseointegration” Quintessence publication
Carl E. Misch “Implant dentistry” 2nd edition, Mosby.
116. Charles M.Weis “Principles and practice of implant
dentistry” Mosby.
Per Ingvar Branemark “Osseointegration and its
experimental background” JPD 1983Vol. 50, 399-410.
Hanson, Alberktson “Structural aspects of the interface
between tissue and titanium implants” JPD 1983 vol.
50, 108-113.
117. T. Alberktson “Osseointegrated dental implants” DCNAVol.
30, Jan 1986, 151-189.
Richard Palmer “Introduction to dental implants” BDJ,Vol.
187, 1999, 127-132.
Geroge A. Zarb “Osseointegrated dental implants:
Preliminary report on a replication study”. JPD 1983,Vol 50,
271-276.
Bergman “Evaluation of the results of treatment with
osseointegrated implants by the Swedish National Board of
Health and Welfare”. JPD 1983, vol. 50, 114-116.