TOPIC: OSSEOINTEGRATION AND MATERIALS
🎯 KEY FACTS
🔹The term osseointegration was coined by P.I. Branemark in 1977.
🔹Minimum period required for osseointegration of the implants in the maxilla is 6 months and for mandible is 4 months.
🔹Implants should be placed after 16 years of age in a young patient once the alveolar growth is completed; otherwise, it leads to submerged implants.
🔹The factors affecting the osteogenic potential of the implant surface are chemical composition, surface energy, surface roughness and surface morphology.
🔹Autogenous bone graft is the gold standard of all the bone grafts, as it gives the best and most reliable results.
🔹Platelet-rich plasma is used for reconstruction of mandible as bone grafts or in sinus lift procedures.
🔹Osseointegration is the apparent direct attachment or connection of osseous tissue to an inert, alloplastic material without intervening connective tissues.
🔹Autogenous bone graft considered gold standards for all other graft materials.
🔍 CLASSIFICATION OF MATERIALS USED IN DENTAL IMPLANTS
✳️ On the Basis of Type of Material Used
👉 Metals:
- Stainless steel
- Cobalt–chromium–molybdenum based
- Titanium and its alloys
- Surface-coated titanium
- Other metals and alloys
👉 Ceramics:
- Bioglass
- Hydroxyapatite
- Aluminium oxide
👉 Polymers and composites
👉 Carbon and carbon silicone compounds
🔍 BIOACTIVE MATERIALS USED IN IMPLANT DENTISTRY
🔸Most commonly used bioactive materials in implant dentistry are ceramic-based materials.
✳️ Ceramic materials can be divided into two types:
- BIOACTIVE e.g. hydroxyapatite, bioglass and beta-tricalcium phosphate; these materials exhibit chemical contact with the host bone.
- BIOINERT CERAMICS e.g. aluminium oxide and titanium oxide; these materials do not bond directly to the bone but are mechanically held in contact with the host bone.
🔎 CLASSIFICATION OF BIOACTIVE MATERIALS
🔶 On the Basis of Structure
- Dense crystalline—least resorption of bone occurs
- Amorphous—faster resorption occurs
🔶 On the Basis of Porosity
- Dense—least resorption occurs
- Macroporous—larger spaces and slower resorption
- Microporous—smaller spaces and faster resorption
🔶 On the Basis of pH
- Low pH—all CaPO4 compounds resorp rapidly,
- High pH—resorp slowly.
⭐ TYPES OF BONE GRAFT
- Autogenous bone graft
- Allograft
- Alloplast
- Xenograft
⭐ VARIOUS BIOMATERIALS COMMONLY USED
- Hydroxyapatite
- Bioglass
- Bovine-derived anorganic bone matrix material (Bio-Oss)
- Calcium sulphate
- Tricalcium phosphate
🔍 HEALING PROCESS IN IMPLANTS OCCURS IN THREE PHASES:
- Osteophyllic phase
- Osteoconductive phase
- Osteoadaptive phase
🔎 THREE MECHANISMS FOR BONE REGENERATION
- Osteogenesis
- Osteoinduction
- Osteoconduction