The introduction and growing popularity of intraosseous implants has revolutionised restorative dentistry. Successful implants restore complete function to patients in areas of previously missing teeth. Although they may act like teeth, the histological hard tissue reaction to implants is a wound healing process compared to the developmental process involved in natural dentition. In addition, the healing process may vary from case to case depending on factors such as the implant material, surface texture, clinician handling and placement into the peri-implant tissue; all of which will be discussed in the following paper.
Research has identified two healing processes involved post-implant placement; osseointegration (Branemark et al 1977, 1985) or fibrosteal integration (Weiss, 1986). The later is moderated by a fibrous capsule which only provides a loose union between bone and implant. Osseointegration is triggered by direct and intimate contact between the implant and surrounding living bone. A greater success rate is seen in implant procedures which undergo osseointegration compared to fibrosteal integration.
The most common implant material in modern dentistry is Titanium or an alloy variation of the metal due to their biocompatibility properties. Titanium provides a surface for cells to differentiate and proliferate. Furthermore the material is resistant to corrosion which is key when being placed into the moist intraoral environment. Upon exposure to air, a 3-5nm oxide layer forms on the surface of the implant (TiO2) and it is the oxygen within this layer that allows the implant to be accepted as self within the body (Villar et al, 2012).
Significant bone formation i...
... middle of paper ...
...eful option to prevent peri-implantitis and bone loss however, I feel these early assumptions are premature as the antibacterial properties of Zr coatings against the other bacteria involved in peri-implantitis are yet to be investigated.
This review paper not only highlights the complex interactions and processes involved in oral hard tissue reactions to intraosseous implants, but also the development and evolution of research and technology in this area of oral surgery. A clear example of this is the increasing popularity of the Zirconia implant which is now competing with titanium as a first choice material. Developers have identified implants as a restorative treatment option which will only increase in demand and, on this basis; aim to optimize the quality, aesthetics and stability of implants, resulting in a higher percentage of long-term clinical success.
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