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Osseointegration

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Definition

Osseointegration is also defined as : "the formation of a direct interface between an implant and bone, without intervening soft tissue". Osseointegrated implant is a type of implant defined as "an endosteal implant containing pores into which osteoblasts and supporting connective tissue can migrate". Applied to oral implantology, this thus refers to bone grown right up to the implant surface without interposed soft tissue layer. No scar tissue, cartilage or ligament fibers are present between the bone and implant surface. The direct contact of bone and implant surface can be verified microscopically.

Osseointegration may also be defined as :

1. Osseous integration, the apparent direct attachment or connection of osseous tissue to an inert alloplastic material without intervening connective tissue.
2. The process and resultant apparent direct connection of the endogenous material surface and the host bone tissues without intervening connective tissue.
3. The interface between alloplastic material and bone.

History

In 1952, Per-Ingvar Brånemark of Sweden conducted an experiment where he utilized a titanium implant chamber to study blood flow in rabbit bone. At the conclusion of the experiment, when it became time to remove the titanium chambers from the bone, he discovered that the bone had integrated so completely with the implant that the chamber could not be removed. Brånemark called the discovery "osseointegration," and saw the possibilities for human use.

In dental medicine the implementation of osseointegration started in the early 1980s as a result of the work of Prof. Brånemark.

More recently the procedure has been introduced for cranial and maxillofacial reconstruction as well.

Applications

• Dental implants are by far the main field of application
• Retention of a craniofacial prosthesis such as an artificial ear (ear prosthesis), eye (orbital prosthesis), or nose (nose prosthesis)
• Bone anchored hearing conduction amplification (Bone Anchored Hearing Aid)

Theories

Two theories regarding the chemical mechanism by which endosteal implants integrate with bone have been proposed. Osseointegration, as defined above. That type of integration contrasts with fibrosseous integration , in which soft tissu