Osseointegration of Implants

OSSEOINTEGRATION OF Implants

  • Implant is considered as osseointegrated when – no progressive relative movement between the implant & the bone to which it has direct contact.
  • The process of Osseointegration reflects an ANCHORAGE MECHANISM whereby no-vital component can reliably be incorporated into living bone & can persist under all normal conditions of loading.

BIOLOGY OF OSSEOINTEGRATION:

→Bone healing around implant involves activation of sequence of –

1. OSTEOGENIC,

2. VASCULAR,                      events

3. IMMUNOLOGIC    

 

Inflamation → Haematoma at bone-implant interface → Platelet activation, Migration→ Vascularisation → Osteoblast adhesion → Proliferation →Protein Synthesis → Binding of Minerals → Calcified Matrix of Woven Bone → Lamellar bone.

 

FACTORS INFLUENCING OSSEOINTEGRATION:

Factors Enhancement of Osseointegration Inhibition of Osseointegration
  1. Implant related factors
  • Design
  • Chemical composition
  • Surface topography
  • Coatings
  • Inappropriate porosity (Wide/Narrow pores) 
  1. Status of Host bone bed
  • Minimal Surgical Trauma
  • Vascularity & Cellularity of Implantation Site
  • Bone Defects
  • Osteoporosis
  • RA
  • Smoking
  • Advanced Age
  1. Mechanical Stability
  • Primary Implant Stability
  • No micro motion
  •  Excessive Implant mobility
  1. Adjuvant Therapies
  • Bone grafting
  • Osteogenic Coatings ( BMPs, TGF-β)
  • Biophysical Stimulation (PEMF, LIPUS)
  • Systemic administration of Ibandronate & Parathyroid Hormone
  • Irradiation
  • Pharma agents
    (Cyclosporin-A, Methotrexate, Cis-platinum, Warfarin, Indomethacin)