Osseointegration

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Osseointegration ( Latin osseus "bones", integrare "to bind") is a term used in dental implant surgery. It is understood to be a direct functional and structural bond between the organized, living bone tissue and the surface of a stressed bone implant, which is visible in the light microscope range .

In 1966, Per-Ingvar Brånemark was the first scientist to describe the term "osseointegration", which has entered international nomenclature. Dental implantology was scientifically recognized by the German Society for Dentistry, Oral and Maxillofacial Medicine (DGZMK) in 1982.

Biological foundations

Osseointegration is the result of a bony healing process in which the bone cells ( osteoblasts ) grow directly on the implant and achieve a firm attachment to the implant surface. In the course of the surgical implantation of alloplastic materials, primary and secondary necrosis occurs . The primary necrosis represents the tissue trauma and the subsequent apoptosis in the operating area due to mechanical, thermal and osmotic influences. The secondary necrosis is assumed to be a consequence of the operation-related interruption of the vascular microcirculation .

At the same time, endosseous implants create trauma to the bone and, through the incorporation of the implant into the jawbone, lead to exudative or proliferative inflammation . The healing process begins with the gradual remodeling of the peri-implant thrombus in the artificially created bone alveolus, as well as the necrotic marginal zone by sprouting angioblasts and histiocytes . The depth of the iatrogenically traumatized tissue is around 500 μm. In the further course, the remaining bone fragments are broken down by macrophages and osteoblasts . Bone- stimulating cytokines and chemotactically stimulated pre-osteoblasts emerge from the exposed cancellous bone and induce new bone formation.

Diagnosis

A typical light, “hard” knocking sound is characteristic of this composite, in contrast to the dampened, softer knocking sound of a non-integrated dental implant . An osseointegrated implant is immovably connected to the jawbone . With suitable devices, however, microscopic movements can still be measured.

In the x-ray image of an osseointegrated dental implant, no separating dark zone can be seen between the radiologically light-appearing implant and the less light-colored bone. In contrast, a non-integrated implant shows a dark zone as an expression of a non-ossified separating layer between bone and implant. Most of the time, the implant is roughly visible to the naked eye and can then be moved when it is alone and not connected to other implants or teeth by a dental bridge .

See also

literature

Individual evidence

  1. ↑ JR Strub, Türp, JC, Witkowski, S., Hürzeler, MB, Kern, M., Curriculum Prosthetics, Vol. III: Combined and removable prosthetics, implantology, aftercare, psychology. Quintessenz-Verlag (2010) ISBN 3-86867-028-9
  2. ↑ T. Albrektsson, Bone Tissue Reaction, in: Brånemark, PI, Zarb, GA, Albrektsson, T. (Ed.), Tissue-integrated dentures. Quintessenz-Verlag, Berlin (1985) 129-143 ISBN 978-3-87652-536-5
  3. ↑ J. Wiltfang, J., Schultze-Mosgau, S., Influence of the implant bed and implant bed on osseointegration. Zahnärztl Mitt, 2001, 23, 44