Osseointegration

Osseointegration derives from the Greek osteon, bone, and the Latin integrare, to make whole. The term refers to the direct structural and functional connection between living bone and the surface of a load-bearing (as defined by Albrektsson et al. in 1981artificial implant. A more recent definition (by Schroeder et al.) defines osseointegration as "functional ankylosis", where new bone is laid down directly on the implant surface and the implant exhibits primary stability. Osseointegration has enhanced the science of medical bone and joint replacement techniques as well as dental implants and improving prosthetics for amputees.

Osseointegration is also defined as: "the formation of a direct interface between an implant and bone, without intervening soft tissue".Osseointegrated implant is a type of implant defined as "an endosteal implant containing pores into which osteoblasts and supporting connective tissue can migrate". Applied to oral implantology, this thus refers to bone grown right up to the implant surface without interposed soft tissue layer. No scar tissue, cartilage or ligament fibers are present between the bone and implant surface. The direct contact of bone and implant surface can be verified microscopically.

Osseointegration may also be defined as :

Osseointegration was first observed—albeit not explicitly stated—by Bothe, Beaton, and Davenport in 1940. Bothe et al. were the first researchers to implant titanium in an animal and remarked how it had the tendency to fuse with bone. Bothe et al. reported that due to the elemental nature of the titanium, its strength, and its hardness, it had great potential to be used as future prosthesis material. Osseointegration was later described by Gottlieb Leventhal in 1951. Leventhal placed titanium screws in rat femurs and remarked how "At the end of 6 weeks, the screws were slightly tighter than when originally put in; at 12 weeks, the screws were more difficult to remove; and at the end of 16 weeks, the screws were so tight that in one specimen the femur was fractured when an attempt was made to remove the screw. Microscopic examinations of the bone structure revealed no reaction to the implants. The trabeculation appeared to be perfectly normal." The reactions described by Leventhal and Bothe et al. would later be coined into the term "osseointegration" by Per-Ingvar Brånemark. In 1952, Per-Ingvar Brånemark of Sweden conducted an experiment where he utilized a titanium implant chamber to study blood flow in rabbit bone. At the conclusion of the experiment, when it became time to remove the titanium chambers from the bone, he discovered that the bone had integrated so completely with the implant that the chamber could not be removed. Brånemark called this "osseointegration", and, like Bothe et al. and Leventhal before him, saw the possibilities for human use.

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