Osseointegration in Dental Implants: A Literature Review

نویسندگان

  • Shikha Nandal
  • Pankaj Ghalaut
  • Himanshu Shekhawat
  • Priya Nagar
چکیده

Osseointegration of dental implants refers to the process of bone growing right up to the implant surface. No soft tissue connects the bone to the surface of the implant. No scar tissue, cartilage or ligament fibers are present between the bones and implant surface. The direct contact of bone and implant surface can be verified microscopically. When Osseointegration occurs, the implant is tightly held in place by the bone. The process typically takes four to six months to occur well enough for the implant dentist to complete the restorations. This article provides a comprehensive review of osseointegration in dental implants INTRODUCTION: The word osseointegration consists of “os” the Latin word for bone and “integration” derived from the Latin words meaning the state of being combined into a complete whole. The successful management of implant dentistry depends on the meticulous diagnostic, planning and surgical skills of the operator. HISTORY: Professor Per-Ingvar Branemark (1952) working in the laboratory of the vital microscopy, University of Goteberg, Sweden, accidentally discovered that titanium bonded well with bone; a phenomenon which was later termed as osseointegration [1]. Branemark defined it “as a direct contact between the bone and metallic implants, without interposed soft tissues layers” (1969). Later it was modified “as a direct structural and functional connection between ordered, living bone and the surface of a load carrying implant” [2, 3]. In 1970s, there were no meth ods available to section intact bone to metal speci mens [2]. Therefore, the histologic evidence of osseointe gration remained indirect. The first investi gator to clearly demonstrate osseointegration was Schroeder from Switzerland [2, 4] by using new techniques to section bone-implant specimens. They termed this union as functional ankylosis. Adell et al in 1981 [3] reported a success rate of 80-100 per cent after a fifteen-year study of osseointegrated implants in the treatment of edentulous jaws. Misch Bone Density Classification (1988)[5] [Figure 1] Ø D1: Dense cortical bone Ø D2: Thick dense to porous cortical bone on crest & coarse trabecular bone within. Ø D3: Thin porous cortical bone on the crest and fine trabecular bone within. Ø D4: Fine trabecular bone Ø D5: Immature, non-mineralized bone. Studies of the Branemark System over the last 20 years have shown a 10% higher implant failure rate in soft maxillary bone in comparison to the dense bone of the mandible [4]. Figure 1:Misch bone density classification HEALING OF DIFFERENT BONE DENSITIES [5]: 1. D1 bone: a. D1 bone is usually found in anterior mandible. b. Because of poor blood circulation, the cortical bone requires greater healing time compared with trabecular bone. c. Healing occurs by formation of lamellar bone interface (forms slowly at 0.6 microns per day) rather than woven bone (forms rapidly at 80 to 50μm/day) after the initial trauma. Therefore, for complete regeneration of vital bone in this dense structure, 5 months healing time may be required. d. However because of the load bearing capability of bone and the excellent bone implant contact, prosthetic loading of D1 bone start at very early stage. e. Bone-implant contact (BIC) =80%.

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تاریخ انتشار 2014