What is osseointegration?

Osseointegration is a very important concept when we talk about dental implants, and it generates some of the most frequent doubts among our patients: what it is and how it affects them.

In this post we will try to resolve doubts on this subject, and on the relationship between osseointegration and immediate load implantology.

What does osseointegration consist of?

In a very simplified way, we call osseointegration the process in which the bone joins or heals with the dental implant, specifically with the titanium root of the implant.

Osseointegration allows the implant to integrate directly, solidly and durably into the jawbone of the maxilla, improving functionality and long-term results.

The material used in the osseointegration process is titanium, since its characteristics make it a highly biocompatible material and the one that best integrates with the bone. In addition, titanium is light and highly resistant to chemical alteration, thanks to its oxidation layer, which makes it an ideal material to act as the root of the dental implant. There is also another material, zirconium, which has been shown to have similar bone integration characteristics. But there are still doubts about its evolution over the years, as current studies are not conclusive.

Origins of osseointegration

The process of osseointegration was defined in 1952 by Professor Per-Ingvar Brånemark, based on his studies on blood circulation. In his experiments he observed that bone tissue has a strong adhesion capacity to titanium, which led him to design a fixation for the dental implant that, thanks to its screw shape and together with a specific surgical technique, favors this natural osseointegration process between titanium and bone.

Thus, we can say that osseointegration is a physiological phenomenon necessary for the success of the dental implant. Furthermore, the knowledge developed in recent years on osseointegration processes has allowed immediate loading implantology to advance significantly.

The stages of an osseointegration process

The osseointegrated dental implant can be placed using immediate loading implantology protocols, and in the case of a lack of bone, a 3D reconstruction of the jawbone can be performed to perform virtual guided surgery and place the implants safely and predictably where there is bone, however minimal it may be.

1. First, the titanium root of the implant is placed, which replaces the root of the natural tooth that has been lost. It is possible to place it at the time of extraction of the damaged or lost tooth.
2. The osseointegration process begins after 24 h, once the blood clot is established. The reticular material is formed around the implant, which will mineralize as the days go by. This usually lasts between four and six weeks after the implant is placed.
3. The tissue ossifies and adapts to the functional load. This process takes approximately two months.
4. In a final phase, the bone structure matures and mineralizes properly; this phase will last between three and four months. It is then when the provisional teeth fixed on the implants are replaced by the definitive ones.

From these phases we can deduce that the quality of osseointegration improves with the passage of time. That is to say, during the first weeks after implant placement there is still no osseointegration. Three months after the placement of the implant, the union between the implant and the bone has already taken place, which becomes firmer and more resistant after six months.

Factors influencing osseointegration

Osseointegration is a process that, once the implant has been made in the right shape and with the right material, follows its natural course as it is a biological process. However, there are several factors that influence the duration and effectiveness of the result. Some depend on the specific bone physiology of each patient, others have to do with the professional and the materials used, and others with our habits and the treatment we follow.

• The implant used must have passed long-term clinical studies and guarantee a clinical success within the scientifically established standards for each specific case.
• The professional who performs the treatment must have specific and regulated training in order to
• The surgical technique must be carried out under strict disinfection and sterilization protocols.
• In the case of periodontal diseases, these must be fully controlled before proceeding with the implant.
• Smoking has a very negative influence on osseointegration, as it slows down healing and can cause infections in the treated area.
• Oral hygiene is essential for everyone, but even more so in patients who have just undergone implantology surgery, since infections or oral diseases resulting from poor hygiene can affect osseointegration.
• Some diseases such as diabetes may cause the implants not to integrate properly into the bone. The responsible professional should establish the relevant protocols.

Moreover, a procedure with advanced technologies, high quality materials and a surgeon with extensive experience in immediate loading implantology procedures can be decisive factors in the success of the implants and, consequently, of the osseointegration.