Biological Aspects of Dental Implant

A) The periimplant mucosa
• The limited vascular supply of

the perimplant gingival or
alveolar mucosa is more than
that around the teeth, this may
be because of lack of
periodontal (periimplant)
ligament.
Clinical Significance of Absence of
Periodontal Ligament
1- In case of occlusal disharmony absence of

the resilient tissues will prevent intrusion
or migration of the teeth which
compensate for premature contacts in
normal teeth, this is very important if there
are dental implants planed to carry fixed
prosthesis in both jaws.
2- The Use of oral implants in growing
individuals must be evaluated,
because the neighboring teeth and
periodontal tissues will further grow
leading to occlusal disharmony.
3- Implants must not be placed beside

movable teeth because with increasing
masticatory force the movable teeth will
move away from the occlusal forces and
the implants will bear the entire load.
4- Lack of periodontal ligaments will lead to

loss of proprioceptive receptors of the
normal dentition this will reduce the tactile
sensitivity and reflex function so the
clinician should instruct the patient about
the precautions of food intake during the
early period.
A) The Hard tissue interface
• The relationship between
endosseous implants and
bone consists of one of
two mechanisms:-
1- Osseointegration , in which 2 Fibrous integration,
the bone is in intimate contact
in which soft tissues
but not ultra-structural
(fibers or cells) are
contact with the implant,
intimate contact between bone interposed between the
and implant at the electron two surfaces.
microscope level, it occurs in
30% 90% of the implant
cases.
Wound Inflammation Bone
Resorption
Bone
Differentiation Activation of
deposition of growth factors
around osteoprogenitor that attract
Implants cells to
Osteoblasts
osteoprogenitor
cells
• First: woven bone is formed quickly between the
implant and the bone.
• Second: after several months (1 – 2 months) this is
progressively replaced by lamellar bone under the load
stimulation.
• Third: the steady state is reached after about 1 1/2
years.
• Ultrastructurally there is an ultrathin layer (10nm) of
proteoglycan between the implant surface and the
structured bone with no interposed fibrous tissues
After initial healing, woven bone, as characterized After weeks or months, progressively a lamellar
by its irregular pattern, is laid down. bone is laid down, with regular concentric lamellae
• Most of oral implants are exposed to load 2 -3
months after insertion while mostly woven bone
is present, woven bone has:
• A random orientation of the collagen fibrils.
• High cellularity.
• Limited degree of mineralization.
• These factors decrease the biomechanical
capacity of the woven bone and thus occlusal
load should be controlled.
B) The Hard tissue interface
• If the requirements of
bone healing aren't met the
primary stem cell will be
differentiated into
fibroblast and the implant
will be facing scar tissue.
Factors affecting osseointegration
• 1- During the osseointegration

process; a mild inflammatory
response as triggered by
movements or appropriate
electrical stimuli may enhance
the bone-healing response but
above a certain threshold it will
be detrimental.
• If there is movements of the

implant more than 150µm,
differentiation to osteoblasts will
not occur but there will be a fibrous
scar tissue around the implant, so it
is very important to avoid any
occlusal load on the implants in the
early healing period
• 2- The osseointegration process is

affected if the bone is over heated
or crushed during drilling. there
will be a fibrous scar tissue
around the implant
• The critical temperature of bone

cells is 470 for one minute which is
corresponding to the denaturation of
the alkaline phosphatase which is the
main enzyme of bone cells so the
drilling for implants needs profuse
cooling with intermittent drilling
with a moderate speed drilling with
sharp drills
• 3- Bacterial contamination
during implant insertion can
prevent good osseointegration;
so the implants must be placed
under complete aseptic
conditions.
• 4- The oxygen tension is very

important for transformation
of the osteoprogenitor cells
because these cells depend on
the oxidation - reduction
potential of the environment, thus
a proper vascular supply and
oxygen tension are needed
• 5- Osseointegration also is
greatly affected by; implant
surface characteristics such as;
- material properties, surface free
energy (wettability) and
roughness profile.
• So the modification of the

surface characteristics as acid
etching, blasting or increasing the
titanium oxide layer appear to
result in greater bone
apposition to the implant surface
as compared to machined or
turned surface.
NEWMAN, M. G., TAKEI, H., KLOKKEVOLD, P. R.
& CARRANZA, F. A. 2011. Carranza's clinical
periodontology, Elsevier health sciences.

Biological Aspects of Dental Implant

Uploaded by

Copyright:

Available Formats

Biological Aspects of Dental Implant

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Biological Aspects of Dental Implant

Uploaded by

Copyright:

Available Formats

A) The periimplant mucosa

• The limited vascular supply of

1- In case of occlusal disharmony absence of

3- Implants must not be placed beside

4- Lack of periodontal ligaments will lead to

• 1- During the osseointegration

• If there is movements of the

• 2- The osseointegration process is

Factors affecting osseointegration

• The critical temperature of bone

Factors affecting osseointegration

Factors affecting osseointegration

• 4- The oxygen tension is very

Factors affecting osseointegration

• So the modification of the

You might also like