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Osseointegration - The Secret To The Incredible Success Of Dental Implants

The year is 1965. A Swedish orthopedic doctor is making some experiments regarding titanium screws placed into the hip bones of goats. The experiments were not going too well, and the titanium screws were left in the bones of the unfortunate animals for a month or so. Afterwards, when the screws were needed, the good doctor went back to the hipbone to retract the titanium screw. He was faced with a conundrum: he could not take the screws out as they had fused to the bone!

Integration

The good doctor quickly understood that this is a breakthrough, and has implications that far outreach his current field of medicine. This doctor is of course Dr Branemark, the father of the modern dental implant. So he first studied the process by which titanium is absorbed completely and utterly into the bone, and he named the process osseointegration. The bone does not reject titanium and its many alloys, as for some reason that is still being researched, it does not recognize the metal as a foreign body, but instead considers it the same as the rest of its tissue, and tries to integrate the titanium into itself by growing around and through the titanium layer. This is the key to the success of dental implants. The body is made of titanium, and thus the jawbone integrates the dental implant, thereby stabilizing it, and thi is how an artificial implant can replace a tooth root. This is further enforced by having the titanium implant have a porous surface, as this way the bone can grow through the dental implant, completely encasing the dental implant. 

The Process

The process by which this is done is not sufficiently understood. There is a bit of mystery as to why the jawbone does not notice that the titanium is a foreign body. But we have a pretty good understanding of how this works. The process takes anywhere from 3 to 6 months, and involves a slow but steady growing of the bone. At first the bone material will be damaged from having the dental implant screwed into it, but after it recovers from the initial stress of the dental implant placement, osseointegration starts immediately. The bone cells start to grow first where they were damaged and rejuvenate the bone there, while forming new cells that go around and into the dental implant. This way the dental implant is actually a part of the bone, not just placed into it.