Definition
Osseointegration is direct contact between living bone and an implant.1 The ADA explains that the bone grows around the implant and holds it in place.2
Where the term comes from
A 1981 study by Albrektsson and colleagues reported on 2,895 threaded titanium implants placed in the upper and lower jaws.1 Microscopy of removed implants showed bone in direct contact with the titanium surface.1 Soft tissue also adhered closely to the titanium where the implant passed through the gum.1
How long it takes
In the original protocol, titanium screws healed without load for at least 3 to 4 months.1 A Cochrane review (2013) notes that implants have traditionally been kept load-free for 3 to 8 months to allow osseointegration.3 AAOMS describes the first days to weeks as the period when bone and surrounding tissue begin to heal, and the following several months as the period when new bone cells grow and attach to the implant.4 The ADA states the process can take up to several months.2
Some implants receive a tooth on the day of surgery or within a week; this is called immediate loading.3 The Cochrane review of 26 randomized trials found no convincing evidence of a clinically important difference in implant failure between immediate, early and conventional loading in the first year.3
The implant surface
Implant surfaces differ in texture (roughness).5 A systematic review of experimental studies found that moderately rough titanium surfaces (Sa above 1 to 2 micrometres) produced stronger bone responses than smooth or minimally rough surfaces.5 The same review noted that study methods for measuring surfaces varied widely.5
When the restoration goes on
AAOMS states that the final crown or bridge is placed once the implant has bonded to the bone and the gum tissue has matured.4
General information about dental implants. Treatment decisions are made with a licensed dentist.
Sources
- Albrektsson T et al. Osseointegrated titanium implants. Acta Orthop Scand 1981. pubmed.ncbi.nlm.nih.gov
- American Dental Association (MouthHealthy): Implants. mouthhealthy.org
- Esposito M et al. Different times for loading dental implants. Cochrane Database Syst Rev 2013. pubmed.ncbi.nlm.nih.gov
- AAOMS (MyOMS.org): Healing Process for Dental Implants. myoms.org
- Wennerberg A, Albrektsson T. Effects of titanium surface topography on bone integration: systematic review. Clin Oral Implants Res 2009. pubmed.ncbi.nlm.nih.gov
